Tuberculosis (TB) remains one of the leading infectious diseases worldwide and is primarily caused by Mycobacterium tuberculosis, predominantly affecting the lungs. Although standard chemotherapy with first-line anti-tubercular agents such as isoniazid, pyrazinamide, and ethambutol has significantly improved treatment outcomes, prolonged therapy is often associated with serious adverse drug reactions, poor patient compliance, and the increasing emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains. These challenges highlight the urgent need for alternative or adjunct therapeutic strategies. In recent years, medicinal plants have gained considerable attention due to their diverse bioactive phytoconstituents and potential antimycobacterial properties. Several herbal extracts and isolated compounds have demonstrated promising inhibitory activity against M. tuberculosis in preclinical studies. Additionally, certain plant-derived compounds exhibit immunomodulatory and anti-inflammatory effects, which may enhance host defense mechanisms and improve treatment outcomes. This review aims to summarize the pathophysiology of TB, limitations of current synthetic therapies, and recent advances in herbal anti-tubercular agents, emphasizing their mechanisms of action, therapeutic potential, and future prospects in TB management. The use of allopathic medicine in complex disease like tuberculosis is associated with the problem of cross resistance and herbal drugs have proven to be most effective in this context.