Abstract: Drug therapy and surgical treatment are the two primary methods for treating renal tuberculosis. With the increase in drug-resistant strains, some novel anti-tuberculosis drugs, such as Delamanid and Bedaquiline, are being developed and gradually applied in clinical practice. Surgical treatment is suitable for patients with poor responses to drug therapy and those who develop complications. Surgical methods include nephrectomy and partial nephrectomy. As the goal of preserving renal function as much as possible becomes more important, minimally invasive treatments have been adopted, with significant contributions from percutaneous nephrostomy and ureteral stent placement. Additionally, immunotherapy has emerged as a new direction, with immunomodulators such as interferons and interleukins under investigation. This article discusses the status and research progress in the treatment of renal tuberculosis, aiming to provide a theoretical basis for future treatments.