Tuberculosis in pregnancy poses significant risks to both mother and child, requiring early diagnosis and careful management. Drug-sensitive TB can be safely treated with first-line anti-TB drugs, ensuring better maternal and fetal outcomes. However, drug-resistant TB (MDR/XDR) presents additional challenges, necessitating individualized therapy with second-line drugs while balancing safety concerns. Multidisciplinary care, regular monitoring, and timely intervention are crucial in safeguarding the health of both the mother and the newborn.