Introduction – The reduced access to healthcare services during the COVID-19 pandemic disrupted tuberculosis control efforts, leading to a decline in the number of diagnosed tuberculosis cases between 2019 and 2020. A study was conducted in the Bouches-du-Rhône department to examine the pathways and patterns of care-seeking and diagnosis for tuberculosis cases reported between 2018 and 2021. Materials and Methods – The retrospective study examined the medical records of tuberculosis patients treated from 2018 to 2021 by the Bouches-du-Rhône Tuberculosis Control Center (Clat13). Care pathways, including diagnostic delays, were compared between 2018–2019 and 2020–2021. Factors associated with longer diagnostic delays were analyzed using binomial logistic regressions. Results – A total of 518 patients were included in the study. The number of cases decreased during the pandemic (-24%), but trends varied by age group, country of birth, or place of residence. The median patient delay was shorter during the pandemic. The patient delay was more often short among patients in highly vulnerable situations (adjusted odds ratio, aOR = 0.2; 95% confidence interval, 95% CI: [0.1–0.6]). At their first point of care, patients who had consulted a general practitioner were more likely to have experienced a long wait time than those who had visited a hospital emergency department (aOR = 8.2 [3.8–18.7]). Discussion and Outlook – The results suggest a need to strengthen training for general practitioners and to maintain the outreach initiatives implemented to ensure access to care for the most vulnerable during the pandemic.