Tuberculosis (TB) has been a leading killer of mankind since time immemorial. There are four key components in the TB elimination approach. They are known as "Detect-Treat-Prevent-Build". Under the preventive strategy, scaling up of airborne infection control measures is an important step in controlling the global disease burden.This is a narrative review for which we used online databases such as PubMed, Embase, and CINAHL from inception to July 2024. The search terms used include TB, transmission, aerosols, cough, droplet nuclei, Wells-Riley equation, and ultraviolet germicidal irradiation (UVGI). All types of articles were selected.The primary mechanism of transmission of Mycobacterium tuberculosis (M. tb) is the inhalation of small infected droplet nuclei (1-5 µm in diameter) consisting of a few mycobacteria that have the capacity to reach the alveoli. The transmission dynamics of TB can be influenced by various human, environmental, and pathogenic factors. Several mechanisms such as coughing, sneezing, talking, laughing, singing, and normal tidal breathing can produce droplet nuclei.It is crucial to thoroughly understand the mechanisms of TB transmission for a better understanding of TB dynamics. TB is mainly transmitted by droplet nuclei, and preventive strategies should incorporate this mechanism.