Pharmacovigilance studies are a cornerstone to ensure the safety of medicines. The awareness, training, and change in perception among healthcare professionals, patients, and other stakeholders can reduce the challenges of underreporting of adverse drug reactions. Isoniazid (INH), Rifampin (RIF), Pyrazinamide (PYZ), and Ethambutol (ETM) are prescribed as the first line of medicines for the treatment of tuberculosis. The common organ systems found to have adverse drug reactions due to first-line anti-tubercular medications are mainly gastrointestinal system (39%), musculoskeletal system (24%), skin disorders (21%), hepatobiliary system (46.9%), Central nervous system, and many others. The current study has focused on determining the Incidence and prevalence of adverse effects of the first-line medications used for treating tuberculosis in the six districts of Haryana and Delhi. The Incidence of ADRs in Gurgaon is 27.71 per 100,000 population, and 13.86 prevalence in a year. The Jhajjar district has a 7.86 incidence rate for adverse effects and a 3.93 prevalence rate for adverse effects. New antituberculosis drugs are needed to improve treatment outcomes and reduce the Incidence of adverse effects of drugs