Tuberculosis pathology encompasses the structural and functional changes induced in tissues by Mycobacterium tuberculosis infection. In pulmonary tuberculosis, the primary site of infection is the lungs, where the bacteria cause the formation of granulomas—nodular inflammatory lesions aimed at containing the infection. These granulomas can progress to caseous necrosis, where tissue becomes cheese-like in consistency, eventually leading to cavitation and extensive lung damage. Extrapulmonary tuberculosis involves the spread of the bacteria to other organs, resulting in diverse pathological manifestations such as lymphadenitis, pleuritis, meningitis, and osteomyelitis. The pathological changes in tuberculosis are driven by both the bacterial virulence factors and the host’s immune response, which can cause tissue destruction while attempting to control the infection. Understanding tuberculosis pathology is crucial for diagnosing, treating, and preventing the varied forms of this disease.