Abstract Background: Assessment of treatment outcome, monitoring and evaluation of its Risk factors of Directly Observed Treatment are among the major important indicators for performance of tuberculosis prevention and control program. Objectives: The aim of this study was to assess anti-TB treatment outcomes and associated factors among patients with tuberculosis in Districts of Burie zuria, Jabitehinan and Fenoteselam town government owned health institution. Methods: Retrospective data (2012-2016) of tuberculosis patients (n=832) registered for Anti-TB treatments at Districts of Burie zuria, Jabitehinan and Fenoteselam town government owned health facility, were reviewed. Data were entered using Epi-info and transported to SPSS version 20 for analysis. Descriptive Statistics and binary regression models were used to present data. The odds ratio and 95% confidence intervals were calculated. A P-Value of <0.05 was considered statistically significant. Results: The overall treatment success rate was 82.5%. The odds of HIV negative TB patients were about four times more likely to have successful treatment outcome than the odds of TB patients with unknown HIV sero-status (AOR=4.4(1.83,10.79)). Study subjects whose age group is <14 years(AOR=3.6(1.56,8.57)),15-24 years (AOR=1.9(1.09,3.54)) and 25-34years of age (AOR=2.6(1.40,5.15)) were four, two and three times more likely to have successful treatment outcome compared to those age group >50 years of age respectively. Urban dwellers were two times more likely to have successful treatment outcome compared to their rural counterparts(AOR=2.2(1.50,3.33)). Pulmonary tuberculosis patients were also three times more likely to have successful treatment outcome (AOR=2.9(2.00,4.46)) compared to EPTB patients. Conclusion and recommendation: The overall treatment success rate was lower than National Treatment success rate target 87%. Patients who are HIV negative, whose age<14 years, whose age 15-24 years, 25-34years,urban residents and those having Pulmonary tuberculosis TB patients were identified associated factors for successful tuberculosis treatment outcome Keywords: Treatment outcomes, tuberculosis patient, DOTS, North West Ethiopia