Tuberculosis continues to be one of the most important infectious causes of death worldwide. Despite substantial investments and progress made in expansion of directly observed therapy short course (DOTS) strategy, improved treatment completion rates and inadequate case detection remains a major obstacle for global control of Tuberculosis. The global case detection rate has increased from 28% to 60%. However, it is estimated that approximately 50% of patients with tuberculosis are still not diagnosed or treated appropriately. The current diagnostics tests (tuberculin skin test and interferon-gamma release assays) poorly predict who will develop active disease and the therapeutic options available are not optimal for the scale of the intervention that may be required. In this article, we discuss a basis of current understanding of latent TB and highlight their biomarkers. We conclude that the identification new biomarkers which can distinguish various stages within latency are urgently needed in order to prioritize those LTB individuals with the highest risk to reactivate the infection.