Tuberculosis (TB) remains one of the main causes of death from an infectious disease till date. Recent data shows that currently 9.6 million people are infected with TB. Over 95% of TB deaths occur in low-and middle-income countries and it is among the top 5 causes of death for women aged 15 to 44. TB is a leading killer of HIV-positive people and around 1 in 3HIV deaths was due to TB. Furthermore, multidrug-resistant (MDR)-TB and extensively drug-resistant (XDR)-TB is spreading and poses a major threat to progress in global TB control program. The emergence of drug resistant TB strains makes the invention of new molecular scaffold a priority. One of the possible strategies to overcome drug resistance in an economic and simple manner would involve re-engineering and repositioning of some old drugs to obtain derivatives that can work on resistant TB bacilli. These may have enhanced bioavailability, be more effective, and serve as cost-effective substitutes, as compared to new drugs identified through conventional methods of drug discovery and development. In view of this, the present review aims to provide a summarizing report on the derivatives of firstline drugs (isoniazid and pyrazinamide) that have the potential to conquer the resistance to the parental drug and could thus serve as effective alternatives.