Pulmonary tuberculosis (pTB) remains a significant public health challenge, particularly in low- and middle-income countries such as The Gambia, where the disease burden is substantial. Despite advancements in treatment, the long-term health impact on children and adolescents who survive the disease is often not fully addressed. This dissertation evaluates the sequelae of pTB in Gambian children and adolescents, focusing on both physical and psychosocial outcomes while identifying key factors contributing to these outcomes. This research employed a combination of cross-sectional, longitudinal cohort, and qualitative study designs. The first objective involved assessing lung function and health-related quality of life (HRQoL) in children and adolescents previously diagnosed with and treated for pTB. The findings revealed that a significant proportion of these children suffer from impaired lung function, most commonly manifesting as restrictive lung disease. This impairment was strongly associated with declines in HRQoL, particularly in physical functioning, with children and their caregivers reporting substantial challenges in daily activities. These physical impairments are not isolated issues but are closely linked to the overall well-being of the individuals. The second objective was to conduct a review of existing literature on paediatric post-TB lung disease (PTLD). The review found that there were critical gaps in the current research, especially the lack of standardised definitions and measurement tools for PTLD. This makes it difficult to compare findings across studies and hinders the development of practical guidelines for clinical practice, especially for younger children who are frequently excluded from research due to diagnostic challenges. The review also emphasised the need for more focused research on this vulnerable population to better understand the long-term impacts of pTB. The third objective of the research was to determine the prevalence and pattern of residual respiratory impairments at the completion of pTB treatment and to describe how these impairments evolve over a 12-month period. The results showed that over half of the participants had impaired lung function immediately after treatment, and these impairments persisted—and in some cases worsened—over the subsequent year. Several key risk factors were identified, including older age at diagnosis, undernutrition, and the presence of fibrosis on chest X-rays. These factors were significant predictors of long-term respiratory health outcomes, underscoring the need for targeted interventions for at-risk groups. The fourth objective of the study explored the psychosocial dimensions of surviving pTB through qualitative interviews. The research revealed that the physical sequelae of pTB are accompanied by social and emotional challenges, including stigma, social isolation, and disruptions to education and future aspirations. These challenges are not just secondary to the disease but are deeply connected to its physical effects, further complicating the recovery process and impacting the overall quality of life of TB survivors. The findings suggest that the stigma associated with ongoing symptoms, such as chronic coughing, often leads to significant social withdrawal and emotional distress, which in turn worsens the physical health challenges faced by these young survivors. Overall, these findings underscore the multifaceted and interconnected impact of pTB on young people, highlighting the urgent need for a comprehensive approach to TB management. Such an approach should extend beyond just achieving microbiological cure to include long-term care strategies that address both the physical and psychosocial challenges faced by TB survivors. The implications of this research are significant for public health policy in The Gambia and similar settings, as integrating post-TB care into national TB programmes has the potential to improve the overall health outcomes of children and adolescents recovering from TB, ensuring that their recovery is holistic and sustainable.