Tuberculosis (TB) is an infectious disease caused by the aerobic microbe Mycobacterium tuberculosis H(37)Rv. Despite the availability of the Bacille Calmette-Guérin (BCG) vaccine and directly observed treatment, short-course (DOTS), TB is a leading cause of death and affects a third of the world's population. The most important factor associated with disease severity is the development of antibiotic-resistant strains, including multidrug-resistant (MDR)-TB and extensively drug-resistant (XDR)-TB. In order to understand disease pathogenesis, it is necessary to delineate the specific features of M. tuberculosis that enable it to evade the host defense system and contribute to its virulence. Here, we have reviewed the various characteristics, such as cell wall components, virulence genes, and the role of small guanosine triphosphatases (GTPases) in the pathogenesis of TB. GTPases are known to play a crucial role in the survival and pathogenesis of various pathogens. The key role of these proteins involves interference in phagosome maturation arrest, enabling pathogens to survive by escaping from lysozymes and toxic free radicals. This observation provides a new avenue for the development of anti-TB drugs.