Osteoarticular tuberculosis (OATB) is reported to occur in 1 to 3% of tuberculosis (TB) cases. Involvement of ankle and foot is a rare entity which comprises 10% of the OATB cases. The biggest diagnostic dilemma associated with OATB comes due to the fact that it is paucibacillary in nature. Newer diagnostic techniques like light-emitting diode microscopy, mycobacterial growth indicator tube (MGIT) culture system, and nucleic acid amplification test-based techniques could aid now in a quicker and definitive diagnosis of TB. Despite numerous studies on this based on pulmonary TB, there is paucity of literature on diagnostics in OATB, especially foot and ankle TB. Significant work is needed to evaluate the efficacy of various diagnostic modalities which would help in timely management, thereby contributing to a better prognosis. The present review summarizes the modern diagnostic modalities and typing techniques that could aid in the management of foot and ankle TB.