In early 1999, more than 160 senior physicians, public health officials, and nurses met to discuss London's tuberculosis (TB) control program. The program was examined against the public health response of New York City's Bureau of Tuberculosis Control during a 1988 to 1992 epidemic. This article outlines TB epidemiology and control in New York City 10 years ago and in London today to assess whether the kind of epidemic that occurred in New York could occur in London.