Tuberculosis remains a critical public health challenge in densely populated low-income urban centers, where overcrowding, inadequate housing, poor ventilation, and limited access to healthcare services create optimal conditions for Mycobacterium tuberculosis transmission. This study develops comprehensive modeling frameworks to understand TB transmission dynamics and evaluate control strategies in resource-constrained urban environments. The research integrates spatial epidemiological analysis, community engagement frameworks, and health systems strengthening approaches to address the multifaceted nature of urban TB epidemics. Drawing upon evidence from multiple low and middle-income countries, this investigation examines how household crowding serves as a potential mediator of socioeconomic determinants of TB incidence, while simultaneously exploring the role of active case finding, community health volunteers, and targeted interventions in high-burden settings. The modeling approach incorporates Bayesian spatial analysis techniques to identify transmission hotspots and evaluate the effectiveness of various control strategies, including directly observed therapy, contact tracing, and preventive treatment programs. Furthermore, this research addresses the intersection of TB control with broader health system challenges, including the need for sustainable community-based interventions, data-driven decision-making frameworks, and cross-sectoral collaboration (Abass, Balogun & Didi, 2019; Oluyemi, Akintimehin & Akomolafe, 2020). The findings reveal that effective TB control in densely populated urban areas requires integrated approaches that combine biomedical interventions with social determinants of health interventions, leveraging community engagement, mobile health technologies, and innovative service delivery models. This study contributes to the global discourse on TB elimination by providing evidence-based frameworks for resource allocation, program implementation, and policy development in urban contexts characterized by high TB burden and limited resources.