This manual describes policies, protocols and recommendations for the prevention, treatment and control of tuberculosis from the New York City Department of Health and Mental Hygiene (NYC DOHMH). It was written primarily for the medical providers of the New York City Bureau of Tuberculosis Control (BTBC) as a reference guide on tuberculosis diagnosis, treatment and prevention. Originally published in 1993, with subsequent editions in 1997 and 1999, the 4th edition of the manual has been updated to reflect changes in national recommendations and BTBC protocols. We continue to use our modified version of the International Classification of Tuberculosis (see inside back cover) for patient classification