Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection remains a major public health concern globally and in the Philippines. The country continues to face a high burden of TB, multidrug- and rifampicin-resistant TB (MDR/RR-TB), HIV, and HIV-associated TB. Since HIV increases the risk of TB and TB worsens HIV outcomes, co-infection hinders progress toward the End TB Strategy and the UNAIDS 95-95-95 targets. This review summarizes the current knowledge on the epidemiology, prevention, and treatment of TB–HIV co-infection with a focus on the Philippine setting. Key challenges include socioeconomic barriers to care and rising drug resistance. In addition, the lack of an integrated TB–HIV data system disrupts continuity of care and weakens surveillance. Closing these gaps requires a coordinated national response that integrates effective policy with active community engagement. Research-driven and locally adapted strategies will be essential to bring the Philippines closer to its elimination goals.