Tuberculosis remains a very common cause of morbidity and mortality worldwide. Both protection and pathology in tuberculosis are mediated by the cell mediated immune response: a paradox which has proved difficult to dissect. The recruitment to, regulation, and activation of cells within granulomas is orchestrated by multiple interacting cytokines and chemokines. In the murine model of tuberculosis a great deal has recently been learnt about the role of cytokines, especially from mice with selective gene deletions. Similar information from humans has also been gained from patients with novel immunodeficiencies which render them exquisitely sensitive to intracellular infection and also from observational studies. In this article we review these observations and some of our own recent findings which attempt to delineate immunoprotective and immunopathogenic mechanisms during tuberculosis.