Tuberculosis treatment, while effective in combating Mycobacterium tuberculosis, is often associated with a range of side effects that can impact patient adherence and overall treatment success. Common first-line anti-tuberculosis drugs such as isoniazid, rifampicin, pyrazinamide, and ethambutol each carry potential adverse effects. Isoniazid may cause liver toxicity and peripheral neuropathy, while rifampicin can lead to liver dysfunction and red-orange discoloration of bodily fluids. Pyrazinamide is associated with hepatotoxicity and joint pain, and ethambutol may cause optic neuritis, leading to vision changes. Second-line drugs used in the treatment of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) often have more severe side effects, including hearing loss, kidney damage, and psychiatric symptoms. Managing these side effects through regular monitoring, patient education, and supportive care is essential to ensure adherence to the treatment regimen and to mitigate the risk of drug resistance and treatment failure.