Intraocular tuberculosis (TB) remains a diagnostic and management conundrum for both ophthalmologists and pulmonologists. We analyse the efficacy and safety of anti-tubercular therapy (ATT) in patients with intraocular TB and factors associated with favorable outcome. Twenty-eight studies are included in this review, with a total of 1917 patients. Non-recurrence of inflammation was observed in pooled estimate of 84% of ATT-treated patients (95%CI 79 to 89). There was minimal difference in the outcome between patients treated with ATT alone (85% successful outcome; 95%CI 25 to 100) and those with concomitant systemic corticosteroid (82%; 95%CI 73 to 90). The use of ATT may be of benefit to patients with suspected intraocular TB. However, this conclusion is limited by the lack of control group analysis and standardised recruitment and treatment protocols. We propose further prospective studies to better establish the efficacy of ATT and ascertain the factors associated with favourable treatment outcomes.