Tuberculosis is increasing in the United States, particularly in indoor environments such as correctional facilities. Several surveys indicate that the incidence of tuberculosis among incarcerated persons is several times that of the general population. The problem has been further complicated by the recent development of multiple drug-resistant TB (MDRTB) and coinfection with HIV. Correctional facilities are at particular risk of tuberculosis because most inmates come from lower socioeconomic groups and have not had adequate health care, the nature of institutional living, overcrowding in prisons and jails, and lack of a prompt diagnosis. Transmission sources can include repeat offenders, visitors, hospitals and health clinics, the community, other inmates, correctional personnel, and other personnel. A tuberculosis control plan requires administrative support and should include designation of a staff member as the tuberculosis resource person, provision of appropriate inservice education, early identification and containment, completion of the course of treatment, and careful recordkeeping. The collaboration between the health department and correctional personnel of the Hampden County (Mass.) Correctional Center provides an example of a successful effort. Figures, photographs, and 9 references