Tuberculosis is still one of the most common infectious diseases, and frontline medications’ poor solubility, inconsistent bioavailability, and dose-related toxicities pose challenges to current oral treatments. Mycobacterium tuberculosis is the pathogen that causes tuberculosis, an airborne illness that primarily affects the lungs. According to the World Health Organization (WHO), the current 6-month antibiotic regimen cures about 85% of B patients. Long-term oral administration of high-dose anti-B medications, however, is linked to serious side effects and can result in drug resistance. A potential substitute is provided by inhalable nanocrystal formulations, which target treatment where it is most needed in the lungs. The best method for treating lung disease locally and achieving systemic administration for other illnesses is pulmonary inhalation administration. Because inhalable nanocrystal formulations deliver high drug loads straight to the lung infection site, they have emerged as a promising platform to overcome these limitations. Pure drugs stabilized by few excipients make up the majority of nanocrystals, which have improved bioavailability, increased saturation solubility, and quick dissolution. The technology of nanocrystals offers a possible formulation approach for the pulmonary administration of inadequate Soluble medications, as a result of the drug’s reduced particle size, which could be a way to the lungs’ physiological barrier and the drugs’ noticeably higher bioavailability. The administration of pulmonary inhalation has garnered a lot of interest lately. A promising platform that combines pulmonary targeting, enhanced dissolution kinetics, and high drug loading is inhalable nanocrystal formulations. In order to optimize aerodynamic diameters for deep lung deposition, where subsequent disintegration facilitates rapid dissolution and macrophage internalization, nanocrystals can be engineered into nanocomposite microparticles or aerosolizable suspensions. With an emphasis on their potential to improve therapeutic outcomes, decrease systemic toxicity, and enhance pulmonary targeting, this review summarizes recent developments in inhalable nanocrystal formulations for poorly soluble anti-TB medications.