In 2023, tuberculosis (TB) caused 1.25 million deaths among 10.8 million cases, remaining the deadliest infectious disease worldwide. In Germany, incidence declined for decades but rose slightly in 2022-2023, driven mainly by migration from high-prevalence countries (e.g., Syria, Afghanistan, Ukraine). While most cases are pulmonary TB (PTB), 22.8% are extrapulmonary TB (EPTB), which can affect any organ and is often hard to diagnose due to nonspecific symptoms. Diagnosis uses microscopy, PCR, and culture; treatment typically lasts at least 6 months, extended for CNS, bone, or miliary TB. Treatment response is assessed clinically and radiologically; reliable blood-based markers are urgently needed.