The National Hospital for Respiratory Diseases as the Centre of excellence managing patients with respiratory diseases, planned to start 24 bedded fully functional ward to cater COVID-19 patients co infected with Tuberculosis which are transferred from all the hospitals island wide for the further management. A SWOT analysis was conducted by the team and selected female tuberculosis ward (ward 14) to convert to treat male and female COVID-19 patients co infected with Tuberculosis. There were several issues in the identified ward such as damaged and dysfunctional wash rooms and toilets, old and damaged water pipe lines, need of wall oxygen line system with jumbo cylinders, need of a new concreate pathway for transportation of patients and hospital staff. A core group consisted with hospital director and other medical specialists guided this project design. This project was started on 02.07.2021 with the support of local community, well-wisher organizations and hospital staff. Damaged toilets, old pipe lines were repaired, existing building was partitioned with proper isolation facilities, wall oxygen line system was established, constructed a concrete path way, established a patient communication with intercom facilities, CCTV patient monitoring system, established proper zoning system and purified water for staff and patients, accommodation facilities for staff were established. This project was completed within 03 weeks’ period. Admissions for this unit was started 13.08.2021. This project was successfully contributed to manage Covid-19 pandemic in Sri Lanka by providing care for 132 covid-19 patients co-infected with active tuberculosis in nine-month duration.