Although it is widely accepted that LTBI transitioning to ATB results from a disruption of host immune balance and a weakening of protective immune responses, the exact underlying immunological mechanisms that promote this conversion are not well characterized. This review systematically explores the immunoregulatory mechanisms in LTBI and ATB, along with their practical applications. Abstract Nearly one‐fourth of the global population is infected by Mycobacterium tuberculosis (Mtb), and approximately 90%–95% remain asymptomatic as latent tub...