This study aims to assess the knowledge, attitudes, and practices of village doctors based on current national policies and to explore factors determining their roles in the directly observed therapy, short course (DOTS) strategy and tuberculosis (TB) control in rural China. In this cross-sectional study conducted in Shandong Province, we interviewed a total of 1,824 village doctors from 36 villages using a semi-structured questionnaire that included demographic characteristics, knowledge of TB treatment and current policies related to TB prevention and control, attitudes towards TB patients, and practices of educating rural residents, detection of TB cases, and supervision of patients. Results indicated that most village doctors underwent a training program and were willing to receive additional training while almost half recognized that their current knowledge was insufficient to meet the demands of their work. Village doctors implemented health education regarding TB control in a variety of forms for rural residents. Some practices of village doctors were inappropriate and remain so. In conclusion, this study revealed the need to provide sufficient, practical, and feasible training programs in order to administratively regulate the practices of village doctors and the need to enrich the content of incentives with increased financial subsidies.