The role of the public health department in TB is a critical component of the overall TB control effort. This article illustrates both the traditional public health methods of surveillance, containment and prevention, and some of the newer strategies being employed to address TB control in today's multifaceted environment. It shows that controlling TB will require an intensification of collaborative efforts between public, private and community providers. In particular, the role of public health and health care workers in institutional settings is emphasized as it relates to shared community efforts. In light of the recent outbreaks of drug-resistant disease and the associated dramatic increasing TB morbidity and mortality, the need for these partnerships is urgent. Given the legal mandate for TB control, health departments will continue to play a major role in the elimination of this disease. The deterioration of these public health services, however, will require immediate attention lest the very foundation of TB control be allowed to crumble.