Background: In India, around 1.98 million cases of tuberculosis (TB) during 2015, representing one-fifth of the global incidence. The initial default is a potential complicating issue, particularly in cases of smear-positive patients because they may continue spreading the disease. The purpose of the study to identify and explore needs required among initial defaulters during TB treatment by using descriptive, exploratory design. Materials and methods: Qualitative exploratory approach, descriptive design, and purposive sampling technique adopted among 29 initial defaulters of TB treatment from the lab register in chest clinic, Puducherry. In this study, a structured interview schedule was used to assess the selected demographic variables, and an open-ended questionnaire was used to identify the factors influencing initial defaulters of TB treatment. Results: The result reveals that there is a significant association (p < 0.05) found in selected demographic characteristics like age, gender, educational status and occupation, type of family, and family history of TB with a minimum duration of 2 years among initial defaulters of TB treatment. Conclusion: The result of this study shows that there is a need on exploring the health needs among the majority of the initial defaulters need regarding awareness on treatment of TB including defaulters and initial defaulters, enforcing to know the importance of completing the course of treatment, 17 of them were asking facilities like cycle and slippers as well as access of drug through the health workers.