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Many people do not take their medication as prescribed. The consequences of this for chronic and debilitating infections like tuberculosis are serious and can include prolonged periods of infectiousness, relapse, emergence of drug-resistant Mycobacterium tuberculosis isolates, and increased morbidity and mortality. Our review considered trials of education and counselling in promoting adherence to the treatment of both latent (dormant) and active tuberculosis. We identified three very low quality evidence trials involving a total of 1437 participants that evaluated education and counselling interventions in promoting adherence to completion of medication for treatment of latent tuberculosis. Two of these studies demonstrated a beneficial effect of education and counselling upon adherence to drug treatment, whereas one did not. There were substantial differences between trials with respect to populations targeted, interventions chosen and outcomes measured. The existing evidence is insufficient to guide policy on the use of education and counselling to promote adherence to tuberculosis therapy.