<p>This scoping review synthesises the current evidence on Video Observed Therapy for people with Tuberculosis (TB). Accessing Directly Observed Therapy (DOT) is associated with out-of-pocket costs, lost income, and stigma. Video Observed Therapy (VOT) is an alternative to DOT. To explore this, as part of a pilot study evaluating VOT amongst people with multi-drug-resistant TB in Mozambique, we did a scoping review to inform a national, multisectoral participatory workshop. We systematically searched five scientific databases and key grey literature repositories and identified 71 records: 49 primary studies, 16 reviews, and six grey literature documents. Data were extracted into four implementation theme categories: Feasibility, Acceptability, Cost, and Effectiveness. Content analysis described implementation successes and challenges, comparing VOT versus DOT. VOT implementation was narratively reported to be feasible, acceptable, with similar effectiveness and lower cost to the health system than DOT, but studies conducted were predominantly from urban and high-income settings. In Low and Middle Income Countries (LMICs), VOT uptake was reported in studies where participants received mobile phones, data packages, and training. The evidence on effectiveness, cost-effectiveness and scalability of VOT in LMICs, where TB burden is highest, remains limited. Further context-specific research, including randomised controlled trials RCTs and implementation studies, is needed to inform VOT adoption in LMICs.</p>