Introduction: More than half (56%) of tuberculosis cases reported in France involve people born abroad. Our study evaluated screening for active tuberculosis (ATB) among migrants in precarious situations seeking care at a Médecins du Monde primary care center. Materials and Methods: We compiled a systematic retrospective case series including all new patients who visited the Médecins du Monde Reception, Care, and Referral Center (Caso) in Paris from January 1 to December 31, 2012. Medical records were analyzed to determine whether TB screening had been performed, what the result was, and what course of action was taken based on the result. A questionnaire was administered to the center’s practitioners to assess their knowledge and motivation regarding screening. The main analysis focused on whether or not TM screening via chest X-ray was performed. Results: During the study period, 2,904 new patients were seen at the Caso in Paris. A chest X-ray was offered to them either when clinical symptoms were suggestive of TM or as a routine procedure, regardless of the reason for the visit. It was thus offered to 37% of new patients, and 31% underwent the test. It was deemed abnormal in 55 patients (6%). Of these, 24 were lost to follow-up (44%). Antituberculosis treatment was initiated for 5 patients (9%), active surveillance was conducted for 6 patients (11%), and no treatment was administered for 20 patients (36%). The prevalence of MT was estimated at 172 per 100,000 in this population. Conclusion: This study describes the tuberculosis screening procedures at the Caso de Paris, one of the few healthcare facilities accessible to foreigners excluded from the healthcare system. It highlights the high prevalence of MT in this population. Shortcomings in the organization of screening are analyzed, and suggestions for improvement are proposed.