Background: Tuberculosis (TB) is a major public health problem in India. Ten percent of all patients with TB have CNS involvement. Delayed diagnosis of this disease is associated with increased mortality. This study assesses the clinico-radiological features as well as outcomes in patients with various forms of CNS TB. Methods: A prospective observational study conducted at tertiary care centre Mumbai between January 2020-July 2022.Each patient was assessed from admission to 3- month follow up. Detailed clinical examination including lab examination was done. All patients were divided into different categories based on Singhal staging and Modified MRC grading for TBM. APACHE 2 score was evaluated for severity of illness. Outcome was measured in terms of mortality and morbidity. Results: Our study had 70 patients with a mean age of 38.94 ± 20.75 years. Fever was the most common symptom in patients with TBM (98.57%).Of total 70 enrolled cases it was found that 57(81.43%) patients survived whereas 13(18.57%) were expired. Co infection with HIV, HBV as well as basal exudate, hydrocephalus, infarct and tuberculoma on CT were significant predictor for mortality in CNS TB. Conclusions: Mortality rate in CNS TB is high. With optimal medical management and timely surgical interventions like Ventriculoperitoneal shunt , External Ventricular Drain (EVD), Decompression Craniotomy many lives can be saved.