Tuberculosis is a major public health problem, especially in developing countries. The clinical manifestations of tuberculosis are very nonspecific and may mimic many other conditions. An accurate diagnosis is extremely important as the disease is treatable with antituberculous therapy. Cytological examination can provide useful diagnostic material for routine and ancillary techniques for rapid and accurate diagnosis of tuberculosis. Here we review the different morphological patterns of tuberculosis, challenges, and application of ancillary techniques for cytological diagnosis of tuberculosis.