Modern treatment strategies for tuberculosis in adults have been greatly improved over the last few decades. Standardized treatment regimens consisting of multiple first-line anti-tuberculosis drugs for 6-8 months can achieve high cure rates. Treatment success rates have reached up to 87% globally. The spread of multi-drug resistant tuberculosis threatens progress, but newer drugs and shortened regimens are showing promise. Rifampin, isoniazid, pyrazinamide, and ethambutol form the core of standard first-line regimens. Directly observed therapy enhances adherence and outcomes. Monitoring treatment response and managing side effects are key. Guidelines recommend HIV testing for all patients and antiretroviral therapy for those co-infected. Drug resistance testing informs appropriate second-line regimens. Shorter regimens replacing ethambutol with fluoroquinolones achieve similar outcomes. Newer drugs like bedaquiline, pretomanid and delamanid show efficacy against drug-resistant strains.Repurposed drugs, linezolid and clofazamine,have also been used. Clinical trials evaluating 6-9 month regimens for drug-susceptible and drug-resistant tuberculosis show promise. Surgery treats complications. Treatment of extra-pulmonary tuberculosis extends the intensive phase. Pregnancy, breastfeeding, liver or kidney disease require dose adjustment and avoiding certain drugs. Community support and nutrition enhance recovery. Global initiatives have increased political commitment, funding, research, access to diagnostics and medicines. But achieving elimination requires further scale-up of high-quality care, addressing social determinants and health systems gaps. Guidelines must consider risks like ageing populations. In summary, modern strategies have revolutionized tuberculosis treatment. But realizing their full potential demands global solidarity and action to curb this ancient scourge. Short, affordable regimens and new drugs can accelerate progress if made readily available, especially for the underserved. Tuberculosis elimination is challenging yet achievable if we cure both the disease and its perpetuating ills.