Tuberculosis (TB) presents a significant burden for children globally, with India bearing a disproportionate burden. Challenges in diagnosis, underreporting, and treatment complexity are key contributors. Children, especially those under five or immunocompromised, face severe illness or death if TB remains untreated. In fact, 96 percent of all childhood deaths occur in children who do not receive treatment, demonstrating the preventable nature of TB if there was widespread access to accurate diagnostics and timely and effective treatment. In children, diagnosis is further complicated by nonspecific symptoms and difficulties in obtaining adequate sputum samples, leading to underreporting and a lack of awareness and resources. Innovations are vital in addressing these gaps. For instance, improved diagnostic tools to enhance early detection at point-of-care; child-friendly sample collection methods; alternate sample types for TB detection; child-friendly medications and so on, can go a long way in lowering the burden of paediatric TB and work towards zero.