Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis (Mtb) and a major global public health threat. Tumor necrosis factor-alpha (TNF-α) is a class of proinflammatory cytokines involved in various cellular functions such as phagocytosis, apoptosis, proliferation, and mitochondrial dynamics. During Mtb infection, TNF-α not only plays a protective immune role in the pathological process of tuberculosis through three mechanisms: granuloma formation, macrophage response and programmed cell death, but also causes immune damage through excessive production of mitochondrial reactive oxygen species, late apoptosis and necroptosis. Therefore, the expression and regulatory mechanism of TNF-α in tuberculosis are of great research significance, and it can be used as a potential target to help the prediction, diagnosis and evaluation of tuberculosis. Therefore, this article focuses on the expression and related mechanism of TNF-α in tuberculosis, in order to provide theoretical basis for the diagnosis and treatment of tuberculosis