Pathways to care for people with chronic respiratory diseases (CRDs) remain inadequate in many low-and middle-income countries (LMICs). In this opinion piece we describe opportunities for the integration of tuberculosis (TB) and respiratory care, as a means of improving patient outcomes. TB and CRDs are intricately linked in many LMICs. People with pulmonary TB (PTB) and CRDs experience similar symptoms, including breathlessness, cough, and chest pain. They may have similar risk factors for disease, including smoking and occupational exposures. PTB is a direct cause of lung damage in the form of post-TB lung disease. Both groups are often directed to TB services as a first point of contact, where they are known as ‘people with presumptive TB’. However, despite the overlap in risk factors, symptoms, and harms described above, public health and clinical care pathways for TB and CRDs remain almost entirely separate in many LMICs. It is likely that co-ordinated approaches to prevention, diagnosis and care would improve patient outcomes. Strategies may include upstream public health interventions to address shared risk factors, the use of shared diagnostic pathways, the provision of decentralised access to both TB and CRD care, and co-ordinated information provision about the risk factors and symptoms of both conditions. Health-related benefits may include more timely diagnosis of CRDs, improved CRD treatment and care, and reduced inappropriate empirical TB treatment or retreatment. Integrated approach may be particularly timely, given increasing scarcity in global health donor funding. However, we also highlight the need for further data in this space. Robust approaches to the design and evaluation of integrated services are lacking. Observational work describing the core components and potential impact of integrated care, and pilot models of integrated care are much needed to inform person-centred approaches to TB and respiratory care in LMICs.