Tuberculosis (TB) is one of the most serious diseases that have been founded in ancient times and discovered even in the ancient Egyptian mummy. There are great challenges were faced by the medical staff like an early diagnosis and follow-up the improvement of patient's health. Assessment priorities of response to treatment regimen include both monitoring of treatment-induced adverse events, and estimation of biomarkers for treatment response in pulmonary and extra-pulmonary tuberculosis, which is important for the success of treatment. Forty tuberculosis patients of pulmonary and extra-pulmonary were subjected to this study. Blood samples of TB patients were screened for serum biomarkers; Chemokine, Hematology; Hb, Monocytes, Lymphocytes, Neutrophils, WBCs, MCV, MCHC, MCH, PCV. Liver function tests; Aspartate aminotransferase, Alanine aminotransferase, Alkaline phosphatase, Bilirubin, Albumin. Kidney function tests; Creatinine, Urate, and Blood Urea Nitrogen, and the correlation between the parameters were measured for all. The monitoring and follow-up of all enrolled TB patients were assessed for the presence of any adverse effects, and the compliance/adherence to treatment by Isoniazid 300 mg/kg, and Rifampicin 600 mg/kg were recorded during the study period. The results of this study showed that the percentage of pulmonary was 55%, and 45% of extra-pulmonary tuberculosis, total female to male percentage ratio was 42:58. A significant difference was recorded between pulmonary and extra-pulmonary patients of the serum chemokine CXCL8 after one and two months of the treatment by Isoniazid and/or Rifampicin, the serum CXCL8 was increased in pulmonary and decreased in extra- pulmonary TB patients. Studies of the clinical parameters showed that the mean values of liver enzymes were very high in the pulmonary TB patients; AST and ALT were 90.22, 71.22, respectively. A significant difference was noticed in the levels of AST, and ALT between pulmonary and extra-pulmonary tuberculosis. Kidney function parameters showed a difference in creatinine level between the two studied groups. Conclusion of this study described that chemokines play a role in mediating an effective immune-modulatory role during the treatment of TB infection, suggesting that such assessment may be useful for therapeutic efficacy of Mycobacterium tuberculosis infection and the therapeutic drug monitoring for the compliance to TB treatment. Also, the role of the pharmacist in the education of TB patients about their adherence to therapy to get maximum therapeutic efficacy and outcomes.