A composite scaffold drug delivery system (CS-DDS) for osteoarticular tuberculosis therapy has been prepared by loading bi-component drugs into a mesoporous silica nanoparticles (MSNs)-coated porous β-TCP scaffold, which was followed by an additional bioactive glass coating. Such a CS-DDS showed high performances in the local and extremely sustained delivery of the bi-component antitubercular drugs and excellent biocompatibility. N(2) sorption isotherms indicated greatly increased surface area of the composites compared to pure β-TCP scaffold, and the mesopores were around 2.6 nm which were large enough to encapsulate drugs such as isoniazide and rifampicin. The in vitro and in vivo release tests demonstrated extra sustained co-release profiles of rifampicin and isoniazide from such a CS-DDS, and both drug concentrations kept higher than their effective values to kill mycobacterium tuberculosis for as long as 42 days. The hepatic and renal function tests indicated that the CS-DDS had neglectable long-term lesions to liver and kidney.