The Philippines is on track in the detection and cure of tuberculosis (TB) under the Directly Observed Treatment Short Course. However, it is still struggling to meet its target of reducing the incidence and deaths linked with the disease. This Policy Note discusses the barriers that hinder the early diagnosis of TB among the poor living in highly urbanized areas of Metro Manila, Davao, and Cebu. It also aims to develop specific strategies for effective case detection and early diagnosis among the urban poor population. The study reveals that cultural factors remain an important barrier. Specifically, the opportunity costs of going to a health facility induce them to forego or delay treatment. Private health facilities are also preferred over government health facilities for TB consultations and treatments.