The article focuses on litigation that involved the District of Columbia Jail. As part of the ongoing litigation that involves the jail's conditions, a court-appointed expert completed a review of health services, including the program for screening and treating TB. The expert found that inmates with active, infectious, multidrug-resistant TB were not being identified and isolated; further, TB skin tests were being read during the middle of the night in the dark by unqualified personnel; also, inmates with active TB were being given inappropriate and ineffective treatment. Although the Department of Corrections promulgated a TB control policy in response to a court order, it failed to implement the policy; the court imposed a schedule of automatic fines for future violations. This has resulted in some improvement in compliance. In the D.C. Jail litigation, four areas of concern dominated. These were the failure to screen inmates and staff, the failure to isolate infectious inmates, the failure to provide proper treatment, and the need for enhanced ventilation and other structural modification to prevent transmission. This article discusses each of these areas and advises that the failure to combat TB in jails and prisons will not only endanger inmates and staff but will spread the disease to members of the free world through staff and releasees who are carriers.