Background: The GeneXpert® MTB/RIF (hereinafter Xpert) test has demonstrated sensitive detection of tuberculosis (TB) and Rifampicin resistance directly from untreated sputum in less than two hours. India is currently drafting the third phase of its Revised National Tuberculosis Control Programme (RNTCP). This process provides the country's health authorities with an ideal opportunity to revolutionise TB management in the country. The RNTCP is currently conducting a multi–site demonstration study to gather operational evidence to scale up the Xperttest under Indian programme conditions.