Background: The synergy between tuberculosis and the AIDS epidemic, along with the surge of multi-drug resistant isolates of Mycobacterium tuberculosis, has reaffirmed tuberculosis as a primary public health threat. Discovery of novel anti-tubercular entities is a highly complex and, therefore, more rational design strategies based on our increasing understanding of the fundamental principles of protein–ligand interactions are required. The combination of available knowledge of several 3D protein structures with thousands of anti-tubercular small-molecules have attracted the attention of scientists from all over the world for the application of structure- and ligand-based drug design approaches. Objective: In this review, an outline of the recent knowledge concerning rational design that chemists and biomedical scientists are currently using to rapidly identify and design novel anti-tubercular agents is presented. The recent successes in rational design of anti-tubercular agents mentioned in the review could give insights into the wide range of possibilities of using rational drug design methodologies. Conclusion: The key conclusion is that future research through the aid of combined ligand and receptor-based design and chemo-bioinformatics will bring not only new hope, but also create a new class of anti-tubercular drugs that will help millions of patients.