This is the first large population-based epidemiologic study of TB in the foreign-born in the United States and Canada. The cross sectional study will focus on in-person interviews with a random sample of approximately 1,500 foreign-born persons living in the 22 sites of the Tuberculosis Epidemiologic Studies Consortium (TBESC) who were diagnosed with TB in 2003-2004. Epidemiologic data collected for each case will describe the means of diagnosis (through screening for disease or due to symptomatic disease), time from arrival to disease onset to diagnosis and initiation of treatment, immigration status, country of origin, migration in the U.S. or Canada, access/barriers to care (including insurance coverage and cultural barriers), treatment outcomes, and other information that will shed light on missed opportunities for prevention. Additional information will be collected from health department records, national surveillance databases, and record linkage with CDC’s Division of Global Migration and Quarantine. Data obtained from case interviews will provide unique epidemiologic information collected consistently from site to site. These data will be used to identify interventions that can improve each of the three basic TB control activities and inform public health efforts to eliminate TB among foreign-born persons in the U.S. and Canada.