These launch configs will allow you to debug typescript files directly from VSCode. It will honor the tsconfig and resolve node modules properly. You do not need to install ts-node or nodemon, as everything is run using npx.

{
  "configurations": [
    {
      "type": "node",
      "request": "launch",
      "name": "ts-node current file",
      "runtimeExecutable": "npx",
      "runtimeArgs": ["-y", "ts-node"],
      "program": "${file}",
      "cwd": "${fileDirname}",
      "console": "integratedTerminal",
      "internalConsoleOptions": "neverOpen"
    },
    {
      "type": "node",
      "request": "launch",
      "name": "watch current file",
      "runtimeExecutable": "npx",
      "runtimeArgs": [
        "-y",
        "nodemon",
        "-q",
        "--exec",
        "$(echo npx -y ts-node ${file})"
      ],
      "program": "${file}",
      "cwd": "${fileDirname}",
      "restart": true,
      "console": "integratedTerminal",
      "internalConsoleOptions": "neverOpen"
    },
  ],
}

The first one is pretty straightforward. If the file is src/one/two/three.ts, this is the equivalent of:

cd src/one/two
npx -y ts-node three.ts

It's better to use cwd in this way, as this allows for nested tsconfig files as may appear in a monorepo.

The second one had to be a bit sneaky. nodemon has TypeScript support, but

The runtimeExecutable is npx, which allows running modules directly from npm.

This launch config will run the current typescript file in the debugger. This does not require ts-node to be installed, as it runs through npx.

{
  "configurations": [
    {
      "type": "node",
      "request": "launch",
      "name": "ts-node current file",
      "runtimeExecutable": "npx",
      "runtimeArgs": ["-y", "ts-node"],
      "program": "${file}",
      "cwd": "${fileDirname}",
      "console": "integratedTerminal",
      "internalConsoleOptions": "neverOpen",
    },
  ],
}

If you want live reloading, you can use the combination of nodemon and ts-node. Unfortunately, I havent found a way to do this without installing ts-node (see below). As in all cases, I strongly recommend adding it as a devDependency in your project rather than installing globally.

npm i -D ts-node

Then you can use this configuration:

{
  "configurations": [
    {
      "type": "node",
      "request": "launch",
      "name": "watch current file",
      "runtimeExecutable": "npx",
      "runtimeArgs": ["-y", "nodemon", "-q"],
      "program": "${file}",
      "cwd": "${fileDirname}",
      "restart": true,
      "console": "integratedTerminal",
      "internalConsoleOptions": "neverOpen"
    },
  ],
}