The article reviews the evolution of laboratory diagnosis of tuberculosis (TB), emphasizing the importance of early and accurate diagnosis for effective treatment. It highlights the challenges posed by the emergence of multidrug-resistant strains (MDR-TB) and the need for advanced diagnostic methods. The review covers microscopic examination, bacterial cultures (both solid and liquid media), and molecular assays, including LPA and Xpert MTB/RIF. Microscopic methods, while widely used, have limitations, and other techniques are essential for comprehensive diagnosis. Bacterial cultures provide specificity and accuracy for solid media and rapidity and increased sensitivity for liquid media. Molecular tests offer significant benefits in rapid and accurate diagnosis, including drug resistance testing. The article concludes that combined diagnostic methods using multiple techniques are the most effective for TB diagnosis, and improving the quality and accessibility of tests is crucial. The introduction discusses the global impact of TB, the role of laboratories, and the challenges posed by the COVID-19 pandemic. The subsequent sections detail various diagnostic methods, including microscopic examination, bacterial culture, and molecular tests, with a focus on their advantages, limitations, and applications. The article emphasizes the need for advanced technologies and improved diagnostic methods to combat the growing threat of drug-resistant TB.The article reviews the evolution of laboratory diagnosis of tuberculosis (TB), emphasizing the importance of early and accurate diagnosis for effective treatment. It highlights the challenges posed by the emergence of multidrug-resistant strains (MDR-TB) and the need for advanced diagnostic methods. The review covers microscopic examination, bacterial cultures (both solid and liquid media), and molecular assays, including LPA and Xpert MTB/RIF. Microscopic methods, while widely used, have limitations, and other techniques are essential for comprehensive diagnosis. Bacterial cultures provide specificity and accuracy for solid media and rapidity and increased sensitivity for liquid media. Molecular tests offer significant benefits in rapid and accurate diagnosis, including drug resistance testing. The article concludes that combined diagnostic methods using multiple techniques are the most effective for TB diagnosis, and improving the quality and accessibility of tests is crucial. The introduction discusses the global impact of TB, the role of laboratories, and the challenges posed by the COVID-19 pandemic. The subsequent sections detail various diagnostic methods, including microscopic examination, bacterial culture, and molecular tests, with a focus on their advantages, limitations, and applications. The article emphasizes the need for advanced technologies and improved diagnostic methods to combat the growing threat of drug-resistant TB.