Introduction Tuberculosis (TB) in Nigeria is a serious disease that is fast becoming deadly. In Nigeria, the burden and mortality of the disease are high, making it one of the infectious diseases with a significant public health challenge. Aim This paper is aimed at examining the prevalence of TB in Nigeria, with emphasis on one of its strains, namely XDR-TB, and factors promoting the disease and its strains, among others. Methodology A literature search was done about Tuberculosis in Nigeria using the keywords; ‘Drug Resistance; Factors; Infection Rate; Mortality Rate; Nigeria; XDR-TB’ through databases such as PubMed, ResearchGate, Google Scholar and World Health Organization between a 10-year-period. Result We found that Nigeria is among the 10 countries in the world with very high tuberculosis incidence and mortality. A number of factors aid the prevalence of the disease in Nigeria: poverty, malnutrition, overpopulation and overcrowding, ignorance, stigma and discrimination, etc. When it comes to the diagnosis of tuberculosis, Nigeria encounters a lot of challenges. For instance, the country lacks access to quality diagnostic facilities, the healthcare system is ill-equipped, and a good number of the populace lacks the necessary awareness about the dangerous nature of the disease. Conclusion The Nigerian government, health workers, key stakeholders, and communities, both affected and non-affected, should all come together to fight off Tuberculosis and its spread in Nigeria. In order to be successful, the eradication effort against TB in Nigeria has to permanently eliminate the causative agent and risk factors everywhere in the country as pathogen prevalence is globally reduced to zero, hence removing the risk of re-infection.