•Tuberculosis is one of the most contagious and lethal illnesses in the world, according to the World Health Organization.•This work presents a biomedical photonic-based sensor that can detect and distinguish accurately between normal and different types of tuberculosis.•The proposed sensor identifies tuberculosis different types with adequate sensitivity and ultra-high-quality factor.•Photonic crystal on-chip are preferable to alternative optical channels because of their durability, compact size, high tensile strength, and inexpensive cost.•The presented sensor exhibited a remarkable sensitivity of 1738.7 nm/RIU, an ultra-high quality factor of 10731, and an extremely small detection limit of 5.87 × 10-6. Tuberculosis (TB) stands as one of the most severe and fatal communicable diseases in the universe, in accordance with the World Health Organization (WHO). Before the COVID-19 pandemic, tuberculosis held the highest mortality rate due to an individual infection, surpassing even HIV/AIDS. The identification of the disease at its initial stages plays a crucial role in patient management and has the potential to enhance the chances of survival. This study presents a unique biomedical sensor based on a two-dimensional (2D) photonic crystal, which demonstrates high accuracy in diagnosing and distinguishing between regular and irregular strains of tuberculosis bacteria. The proposed sensor is designed, presented, and evaluated. It can identify different types of tuberculosis with ultra-high-quality factor and adequate sensitivity in comparison with related photonic detection methods. Also, the presented sensor features a simplistic design with a fabrication possibility using current technologies. The presented sensor exhibited an ultra-quality factor of 10731, an extremely small detection limit of 5.87 × 10-6, and a remarkable sensitivity of 1738.7 nm/RIU. A comprehensive overview of non-optical sensing methods is addressed and linked to the current work. A detailed comparative exploration of this study and associated photonic-based literatures are carried out to verify the efficiency and originality of the proposed sensor.