Precision medicine is emerging as a transformative approach to tuberculosis (TB) treatment, holding the potential to significantly shorten therapy durations from the current standard of 4-6 months. This individualized strategy moves beyond a 'one-size-fits-all' regimen by considering specific patient characteristics, the genetic profile of the *Mycobacterium tuberculosis* strain, drug susceptibility, and the host's immune response. By aligning the intensity and duration of therapy with a patient's clinical phenotype, precision medicine can optimize drug dosages, reduce toxicity, and enhance treatment efficacy. The traditional lengthy TB treatment regimens often pose challenges regarding patient adherence, which can contribute to treatment failures and the emergence of drug-resistant strains like Multi-Drug Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB). Shorter, more personalized treatments are expected to boost adherence rates and improve overall outcomes, particularly for challenging cases of drug-resistant TB. Indeed, new clinical practice guidelines already recommend shorter all-oral regimens, such as four-month options for drug-susceptible TB and six-month regimens for rifampin-resistant TB, for eligible individuals. While the prospects are promising, realizing the full potential of precision medicine in TB treatment requires addressing several challenges. These include the need for advanced diagnostic tools, genomic sequencing, pharmacokinetic studies, and robust data management systems. Further adaptation and validation through clinical trials are essential before broad implementation, especially in resource-limited settings where access to such technologies may be constrained. For countries like India, which bears a disproportionately large burden of global TB cases and deaths, these advancements are critically important for improving public health outcomes. Ongoing research aims to refine these approaches, moving towards truly tailored and more effective TB therapies worldwide.