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Advanced molecular diagnostics, including rapid assays, have improved resistance detection; however, resource\u2010limited settings remain underserved. Nanotechnology\u2010based drug delivery systems, including polymeric carriers, solid lipid nanoparticles, and silver nanoparticles, can provide targeted delivery, prolonged release, and improved bioavailability. Drug repurposing strategies using existing drugs like linezolid, celecoxib, and nitazoxanide also show a promising option in combating drug\u2010resistant TB while reducing treatment duration. Host\u2010directed therapies (HDTs) and natural products offer complementary strategies by enhancing host immune responses and providing multitarget antimycobacterial effects. This review emphasizes the drug resistance mechanisms and advancements in novel theranostics. 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