Mycobacterium tuberculosis infection causes high rates of morbidity and mortality. Host-directed therapy may enhance the immune response, reduce tissue damage and shorten treatment duration. The inflammasome is integral to innate immune responses but over-activation has been described in tuberculosis (TB) pathology and TB-immune reconstitution syndrome. Here we explore how clinical isolates differentially activate the inflammasome and how inflammasome inhibition can lead to enhanced bacterial clearance. Wild-type, Nlrp3 −/− /Aim2 −/− , Casp1/11 −/− and Asc −/− murine bonemarrow derived macrophages (BMDMs) were infected with laboratory strain M. tuberculosis H37Rv or clinical isolates from various lineages. Inflammasome activation and bacterial numbers were measured, and pharmacological inhibition of NLRP3 was achieved using MCC950. Clinical isolates of M. tuberculosis differed in their ability to activate inflammasomes. Beijing isolates had contrasting effects on IL-1β and caspase-1 activation, but all clinical isolates induced lower IL-1β release than H37Rv. Our studies suggest the involvement of NLRP3, AIM2 and an additional unknown sensor in IL-1β maturation. Pharmacological blockade of NLRP3 with MCC950 reduced bacterial survival, and combined treatment with the antimycobacterial drug rifampicin enhanced the effect. Modulating the inflammasome is an attractive adjunct to current anti-mycobacterial therapy that warrants further investigation. Although significant strides have been made in reducing the disease burden attributed to TB, it remains a considerable cause of mortality. Current figures estimate that 1.6 million people died from TB in 2017 1. Progress has been impeded by the rise in drug resistance and the HIV-epidemic. However, it is the ability of the bacterium to modulate its metabolism within the host environment 2 , enter non-replicating persistence 3 and form biofilms 4 in order to facilitate its own survival that leads to treatment difficulties 2. Treatment of M. tuberculosis necessitates a prolonged multi-drug regimen 5. Anti-microbials target actively replicating bacteria, but the intracellular population is composed of a mixed phenotype, requiring extended therapy to eradicate those bacterial populations that transiently and stochastically leave the slowly replicating state to enter an actively replicating state 5. However, the extended treatment is associated with non-compliance and selection of resistant mutations. To identify alternative anti-mycobacterial therapies efforts have been directed at altering the host immune response through host-directed therapy (HDT), which is to be used as an adjunct to standard quadruple therapy. Deregulated host immune responses may be counter-productive to bacterial killing and lead to tissue destruction, such that half of TB-survivors have some degree of persisting lung damage following successful microbiological cure 6. Thus, the host response may be manipulated in two ways; firstly by augmenting bacterial killing and secondly by rebalancing the inflamm...