This white paper, authored by leading medical directors at IQVIA, provides an in-depth analysis of the current landscape, challenges, and opportunities for conducting tuberculosis (TB) clinical trials in the Asia Pacific region. With Asia Pacific accounting for a significant proportion of the global TB burden—including high rates of drug-resistant TB—the paper explores the complexities of trial design, patient recruitment, site selection, and regulatory requirements. It highlights the importance of adopting WHO guidelines, leveraging digital adherence technologies, and addressing patient-related, treatment-related, and health system challenges. The asset offers actionable recommendations for pharmaceutical sponsors, CROs, and healthcare stakeholders seeking to optimise TB clinical research, improve patient outcomes, and accelerate the development of new diagnostics, treatments, and vaccines. Through a focus on practical solutions, innovative approaches, and regulatory developments, this white paper sheds light on what’s needed to accelerate TB clinical trials and improve public health impact across Asia Pacific.