Aim: To hepatoprotective effect of N-acetyl cystein on the patient receiving at in tertiary care centre. Material & Methods: Study will be conducted on 50 newly diagnosed pulmonary TB and treatment naïve patient from the Department of TB and CHEST at Index Medical College, Research centre and Hospital, Indore and all the tests will be performed with due permission from the Institutional Ethical Committee and informed consent from the subjects or their legal relatives. Subjects were included on the basis of their diagnosis of TB as per RNTCP guidelines. A rise of five fold in ALT over upper normal limit in the absence of symptoms and any increase in serum bilirubin. Results: For the Sample size of 50 patients, 24 used the NAC drug & 26 were not administered NAC Drug. Without the use of NAC Drug : The Mean SGOT variation was observed from 40.23 to 123.65 from the 1st week to 3rd week, Mean SGPT from 34.31 to 77.38 and MeanBilirubin variation was from 0.37 to 0.48. As per the study, to study the hepato-protective effect of N-acetyl cystein on liver injury induced by anti TB drugs 24 patients were administered NAC drug. It was observed & documented that Mean SGOT variation from the 1 st week to the3 rd week, the change was from 26.92 to 29.92, Mean SGPT variation was from 23.67 to 29.0 and the Mean Bilirubin variation observed was from 0.40 to 0.46. The percentage change is very visible on comparison of the use of NAC drug vis-à- vis NAC drug not administered. The percentage change of SGOT was 111.15% in NAC used patients (p-value 0.0036) & 307.36% in patient not given NAC drug (p-value 0.0009). SGPT percentage change was 122.51% (p-value 0.0005) as compared to 225.56% for Patient not on NAC drug (p-value 0.0009) and Bilirubin percentage change was 115.30% for patient on NAC drug (p-value 0.0050) & 127.31% for patient not onNAC drugs (p-value 0.0301). Conclusion: Isoniazid, rifampicin, and pyrazinamide, the first-line antituberculosis (anti-TB) drugs are associated with hepatotoxicity. Patients treated with antituberculosis drugs may experience hepatotoxicity ranging from simple hepatic enzyme elevations to severe clinical hepatitis. According to our study results, it could be concluded that NAC acts as an effective antioxidant in the prevention of ATT-induced hepatotoxicity. Administration of NAC produced a significant hepatoprotective effect and effectively reduced lipid peroxidation.