Tuberculosis (TB) remains a major global public health challenge, particularly in low- and middle-income countries where poverty, overcrowding, and limited access to healthcare exacerbate its spread. Despite national control efforts, TB prevalence remains disproportionately high in urban slum communities in Nigeria. This study investigated the epidemiology of TB in selected urban slums of Eberi  Local Government Area, Omuma  State, with a focus on risk factors and preventive strategies. A descriptive cross-sectional survey design was adopted, and 230 respondents were sampled from communities including Eberi, Egbulu, Umerim, Umuagwa and Umudik. Data were collected through structured questionnaires and analyzed using descriptive statistics and Chi-square tests. Findings revealed that 23.5% of respondents reported TB cases within their households or neighborhoods, with Eberi, Egbulu recording the highest burden. Significant socio-demographic and environmental risk factors associated with TB prevalence included overcrowding (72%), poor ventilation (64%), unemployment (43.5%), and low education (30%). Health-related factors such as HIV co-infection (12%, OR=4.1), malnutrition (41%, OR=2.3), and smoking (18%, OR=2.9) were also strongly associated with TB risk. Preventive measures reported included covering the mouth when coughing (49.1%), health education campaigns (51%), and community-based TB screening (37%), although government sensitization programs reached only 22% of respondents. The Chi-square test confirmed significant associations (p < 0.05) between these factors and TB prevalence. The study concludes that TB control in Eberi  requires targeted, community-specific interventions addressing overcrowding, poor ventilation, HIV prevention, nutrition, and smoking cessation, alongside expanded grassroots health education and government-led sensitization.