Pulmonary tuberculosis (TB) remains a significant global health concern characterized by a spectrum of clinical features that vary widely in presentation and severity. The disease primarily affects the lungs but can also involve other organs through hematogenous spread. Typical symptoms include chronic cough, often productive, which may be accompanied by hemoptysis in advanced cases. Patients frequently report constitutional symptoms such as fever, night sweats, and unintentional weight loss, reflecting the systemic nature of the infection. Diagnostic clues often include the presence of a history of exposure to tuberculosis, residence in endemic areas, or immunocompromised status. Physical examination findings can range from normal to signs of advanced disease, including dullness to percussion, crackles, or decreased breath sounds over affected lung fields. Chest radiography remains a cornerstone in the diagnosis, typically revealing infiltrates, cavitations, or miliary patterns depending on the stage and extent of the disease. Laboratory investigations aid in confirming the diagnosis, with sputum microscopy, culture, and nucleic acid amplification tests playing crucial roles. In cases of extrapulmonary TB, additional diagnostic procedures may be required to identify involvement of other organs. Differential diagnosis includes other causes of chronic cough and respiratory symptoms, necessitating careful clinical evaluation and appropriate testing. In conclusion, understanding the diverse clinical manifestations and diagnostic strategies of pulmonary tuberculosis is vital for early detection, effective treatment, and prevention of transmission, thereby mitigating its impact on individual health and public health systems worldwide.