Introduction: India has aimed to eliminate tuberculosis (TB) by the year 2025. Malnutrition has a significant effect on TB treatment outcomes. In this regard, the government of India launched Nikshay Poshan Yojana (NPY) via direct benefit transfer (DBT) in April 2018, providing a financial incentive of Rs. 500 per month to each notified TB case on treatment. The present study was done to assess the status of implementation of NPY. Methodology: A descriptive study was conducted among all the TB patients registered for treatment with a valid NIKSHAY ID during the period January–December 2022 in a TB unit, Bengaluru South, Karnataka. Using a pretested semistructured questionnaire, data were collected from treatment cards, the Nikshay portal, and interviews with the patients or their caregivers. The DBT under NPY was assessed as the number of instalments of the payment received during the treatment course. Data were entered in Microsoft Excel spreadsheet, and the final analysis was done using Statistical Package for the Social Sciences (SPSS) software ver. 25.0. Results: A total of 220 TB patients had registered for treatment during the study period, among whom 171 (77.7%) study subjects could be contacted. Treatment success was seen among 163 (95.3%) of them. The Chi-squared test showed no significance with respect to receiving at least one DBT instalment and treatment outcome. The median out-of-pocket expenditure (OOPE) was a direct cost of Rs. 5,250 [interquartile range (IQR) 2,000–22,000] and an indirect cost of Rs. 5,500 (IQR 1,800–14,500). Conclusion: The NPY implementation needs further improvement, as even after 4 years, complete coverage to all the notified TB patients has not been achieved. Additionally, there is an urgent need to reduce the OOPE incurred by patients, thereby improving treatment success and ultimately achieving TB elimination by 2025.