Introduction: Miliary tuberculosis represents one of the most severe and life-threatening forms of tuberculosis. It is characterized by widespread hematogenous dissemination of Mycobacterium tuberculosis and is associated with significant morbidity and mortality. The present study aimed to describe the clinical, epidemiological, therapeutic, and outcome characteristics of miliary tuberculosis. Methods: We conducted a retrospective descriptive and analytical study over a two-year period, from January 1, 2022 to December 31, 2023. Medical records of patients hospitalized for miliary tuberculosis in the Department of Pneumology and Phthisiology at Moulay Youssef University Hospital, Rabat, Morocco, were reviewed and analyzed. Results: The mean age of patients was 43 years, with a male predominance (64%). A history of tuberculosis was found in 2 patients, and recent close contact with a tuberculosis case was identified in 5 patients. Four cases of miliary tuberculosis occurred following immunosuppressive therapy, including 3 patients who had previously received preventive anti-tuberculosis treatment. The clinical presentation was dominated by fever, night sweats, general condition deterioration, dyspnea, and cough. Extra-respiratory manifestations were observed in 17% of cases. Typical radiological findings were present in 91% of patients, while sputum smear microscopy was positive in 15%. Anti-tuberculosis treatment based on a four-drug regimen (ERIPK4) was initiated urgently in most cases. Complications occurred in 11 patients, including disease-related and treatment-related complications. The in-hospital case fatality rate was 17.7%. Conclusion: Miliary tuberculosis remains a severe and potentially life-threatening condition. Early diagnosis and prompt initiation of appropriate anti-tuberculosis therapy are essential to improve patient outcomes.