With the aging of the population and advances in tuberculosis treatment, the number of elderly patients with tuberculosis is increasing, leading to a rising incidence of tuberculosis combined with lung cancer. The development of TB combined with lung cancer is a complex process involving numerous mechanisms and is the result of the accumulation of a series of factors, including abnormal immune function, drug factors, inflammatory mediators and their associated genetic mutations, persistent infection with Mycobacterium tuberculosis type L, abnormal proliferation of fibers and scar tissue, and retention of carcinogens (charcoal dust, coal tar pitch extract, tobacco, etc.). Tuberculosis remains one of the major infectious diseases that seriously endanger human health in this century, and the incidence of lung cancer is increasing year by year worldwide, along with the incidence of lung cancer with a history of tuberculosis, but the correlation between tuberculosis and lung cancer is not yet conclusive. The mechanisms and factors influencing the occurrence of tuberculosis combined with lung cancer are reviewed here. In conclusion, the occurrence of tuberculosis combined with lung cancer is a complex process involving many mechanisms and is the result of the accumulation of a series of factors. At present, the causes of the occurrence of combined lung cancer based on the history of tuberculosis are not very thorough and clear, and more in-depth and comprehensive studies are still needed. A deeper understanding of tuberculosis combined with lung cancer and a proper understanding of its pathogenesis will help to adopt better targeted prevention strategies and effective treatments at the molecular and cellular levels in the future.