Tuberculosis (TB) remains a significant global health burden, with timely and accurate diagnosis being critical for its management and control. Interferon Gamma Release Assays (IGRAs) have emerged as diagnostic tools for latent and active TB infection. This study compares the clinical efficacy of two IGRA tests, QuantiFERON-TB Gold Plus (QFT-GIT) and T-SPOT.TB, in diagnosing TB in a tertiary care hospital in Central India. We aimed to evaluate their sensitivity, specificity, and operational effectiveness in a real-world clinical setting. Our findings highlight the advantages and limitations of each assay, informing their potential role in improving TB diagnostics in high-burden settings.