Tuberculosis (TB) persists as a serious public health problem in the United States in spite of the fact that effective chemotherapy has been available for over 35 years. Over 20,000 new cases and 1800 deaths still occur each year. The continued occurrence of hundreds of cases in young children is especially alarming, as newborns and children under 3 years of age are at great risk of disseminated disease and its lethal complications. The disease persists in part because many health care providers do not consider it a problem. Nurse-midwives care for a number of groups at high risk of infection (innercity populations, Indochinese and Latin American immigrants, and American Indians) and can be important in helping to eliminate TB. This article provides information about the transmission, epidemiology, and pathogenesis of the disease, as well as guidelines for screening, diagnosis and treatment of TB in both pregnant and nonpregnant women and in newborns.