Abstract Background The feasibility of and advantages of using an unmanned aerial vehicle (UAV) for sputum transportation for TB in Chamba, Himachal Pradesh, India, were evaluated. Methods We conducted a non-randomized interventional study and compared the advantages of sputum transport between UAVs and motorbikes (conventional). Results We completed 151 transportations. Transportation by UAV (7.1±0.8 min) was faster than by motorbike (22.7±4.6 min, p<0.001). Motorbikes covered a greater distance (12.09±1.6 km) than UAVs (2.89±0.35 km, p<0.001). The recurrent cost per transport using an UAV (US${\$}$0.68) was less than by motorbike (US${\$}$1.4). All 26 stakeholders agreed that UAVs would reduce the turnaround time for diagnosis of drug-resistant TB. Conclusions Sputum transportation by UAVs was feasible, cheaper and an efficacious potential alternative to conventional modes of transportation.