This review examines the concurrent infection of Tuberculosis (TB) and Hepatitis B Virus (HBV), with a specific focus on the intricate connections between these pathogens and their effects on public health. The co-infection of TB and HBV poses considerable difficulties in diagnosis and treatment due to the combined immunopathogenic effects of the two diseases and the limitations of existing therapies. Here, we examined the etiology, immunological response, and clinical symptoms of tuberculosis (TB) and hepatitis B virus (HBV) infections, both separately and when they occur together. We emphasized the need for innovative diagnostic biomarkers and sophisticated therapy approaches, such as antibacterial and antiviral medications as well as therapeutic vaccinations, to enhance patient outcomes. We also pointed out that research efforts focusing on personalized medicine strategies and the advancement of novel therapies that specifically target the distinct characteristics of TB and HBV co-infection are imperative. Finally, this review offered a comprehensive impact of dual infection on public health, proposed potential directions for future study and enhancements in clinical management.