Between 1996 and 1999, the incidence rate of active tuberculosis (TB) in Olmsted County, Minnesota, increased by 365%--from 3.4 cases per 100,000 population to 15.8 per 100,000 people. The need for early detection and treatment of TB, efficient care delivery, and cost containment led to the establishment in 2001 of an innovative centralized TB clinic. The clinic was established through a collaboration between Mayo Clinic and the Olmsted County Public Health Department. Following its inception, conversion rates for sputum-positive culture increased from 69.2% to 92%, and the percentage of patients taking part in directly observed therapy increased from 20.8% to 94.6%. Because of successful medical outcomes and acceptance by patients, providers, and the community, the clinic model lends itself to replication elsewhere in the United States.