BACKGROUND : Age of onset of NCDs in developing countries are lesser than developed countries. In India, half of the NCDs occur before the age of 52, suggesting that working adults are largely affected by NCDs. Many remain undiagnosed due to lack of awareness and insufficient access of health care services. Government of Tamil Nadu initiated “NCD-Makkalai Thedi Maruthuvam” (NCD-MTM) program with comprehensive package of doorstep services for ensuring continuum of care and sustainability of health care services. The interventions include screening for hypertension, diabetes, common cancers, delivery of NCD drugs, dialysis bags for CKD patients, home-based palliative care services and physiotherapy services. With one year of its implementation, we did a qualitative study to understand the challenges in its implementation. We reviewed the program documents, guidelines and review reports. We selected the stakeholders across all levels of care by purposive sampling and conducted in-depth interviews. We audio recorded, transcribed, generated codes, and did thematic analysis by free listing and pile sorting and identified seven thematic areas – Human Resources, screening of NCDs, referral linkages and follow-up, delivery of drugs, reporting system, monitoring and supervision, and IEC/BCC. Similar community-based interventions in other parts of the world have proved much more beneficial particularly involving primary health care staff compared to that of the standard care. Though the program had widely covered the target individuals, especially in drug delivery, and creating awareness, stakeholders have reported many challenges in implementation of the program. The most important areas of focus are the need of coordination among field level staff, uninterrupted supply of equipment and consumables, focus on follow-up and referral, effective reporting system, proper supervision plan and IEC/BCC strategies. Rectifying the reported challenges with appropriate solutions will make this program a successful model and will help in bringing desirable NCD outcomes.