Introduction and aim. India, accounting for approximately 26% of the global tuberculosis (TB) burden with a significant proportion of 0.11 million (6%) pediatric TB cases. The goal of this systematic review paper is to provide a thorough analysis of the TB epidemic in India, including information on the severity of the illness and challenges associated with diagnosis and treatment, the risk factors for transmission and progression of the disease, and the advancements and difficulties encountered in efforts to control at community level. Material and methods. The terms “Tuberculosis in India,” “Drug-Resistant Tuberculosis,” “Tuberculosis and Associated Co-morbidities,” “Diagnosis of Tuberculosis,” “Prevention of Tuberculosis,” and “Treatment of Tuberculosis’’, keywords were used to search in number of international electronic databases, including “Google Scholar,” “PubMed,” and “DOAJ.” Analysis of the literature. Diagnosis and treatment of TB are significantly complicated by co-morbid condition such includes alcoholism, diabetes, HIV, undernutrition, diabetes and HIV. In addition, there may be treatment delays, and the extra-pulmonary or drug-resistant TB due to ignorance, misunderstandings, and lack of education among TB patients, and medical professionals, which ultimately increases morbidity and mortality. Conclusion. Poverty, undernutrition, inadequate healthcare infrastructure, and co-morbidities, which frequently complicate TB diagnosis and treatment, must be addressed in addition to the critical need to prioritize TB research and development.