Tuberculosis (TB) remains a significant public health challenge in the New York-Newark-Jersey City metropolitan area, despite targeted interventions by the New York City Department of Health. This study examines the influence of demographic characteristics—including race/ethnicity, age, and sex—alongside treatment-related factors such as therapy completion and drug susceptibility, on TB incidence from 1993 to 2017. Previous research has shown that non-Hispanic Asians, non-Hispanic Blacks, and Hispanics consistently experience higher TB incidence compared to non-Hispanic Whites in this region. Socioeconomic and lifestyle factors, including poverty, alcohol consumption, tobacco use, poor housing conditions, and limited access to TB care, have been identified as contributing to this disparity. Using longitudinal data spanning nearly 25 years, this study investigates the relationship between demographic variables and TB outcomes, emphasizing the impact of therapy completion within one year and susceptibility testing for isoniazid and rifampin. Findings indicate that race/ethnicity, age, and sex are significant predictors of TB incidence, with non-Hispanic Asians, non-Hispanic Blacks, and Hispanics bearing the greatest burden, regardless of gender or age group. In contrast, non-Hispanic Whites consistently show lower TB incidence, highlighting persistent disparities in TB distribution. The study underscores the importance of integrating demographic insights into TB control strategies and tailoring interventions to address the specific needs of high-risk populations. Strengthening therapy adherence, ensuring timely drug susceptibility testing, and addressing socioeconomic determinants are critical for reducing TB incidence and closing the gap between vulnerable and lower-risk populations. These findings provide valuable guidance for policymakers and public health practitioners aiming to enhance TB prevention, treatment, and control programs in diverse urban settings.