Tuberculosis (TB) remains a global health concern, affecting millions worldwide. This comprehensive review aims to provide an update on the current understanding of TB diagnosis, treatment, and management strategies. We discuss the epidemiology, pathogenesis, and clinical manifestations of TB, as well as recent advances in diagnostic techniques, including molecular tests and imaging modalities. The review focuses on current treatment regimens, including first-line and second-line therapies, and explores emerging treatment strategies, such as host-directed therapies and vaccine development. We also examine the challenges posed by drug-resistant TB, co-infections (e.g., HIV), and comorbidities. Furthermore, we highlight novel research directions, including nanotechnology-based drug delivery systems and immunotherapies. Our review underscores the need for continued research, improved healthcare infrastructure, and enhanced global collaboration to combat this ancient yet persistent disease.