The Paris Tuberculosis Control Center (CLAT 75) currently consists of a coordination unit and four medical-social centers. The data presented here were collected as part of CLAT 75’s activities regarding tuberculosis cases among residents of Paris in 2010. The reported incidence rate of active tuberculosis among Paris residents was 22.7 per 100,000 in 2010, three times higher than the national rate (8.1 per 100,000). It has decreased by approximately 60% over 8 years (54.1 per 100,000 in 2002). In 2010, individuals in precarious or highly precarious situations accounted for 26% of cases; 73% of patients were born abroad, half of whom in sub-Saharan Africa. The organization of Clat 75 has undergone significant changes over the past decades to better control the disease. Case investigations have been expanded. Mobile radiological screening efforts have been tailored to the most at-risk populations, particularly people living in migrant communities and/or in highly precarious conditions. Care for patients in precarious situations has been strengthened, in collaboration with hospital services and the Samu Social. Tuberculosis remains a public health problem in Paris, as it does generally in large urban areas. While epidemiological indicators are encouraging, CLAT 75 must nevertheless continue to modernize and adapt its activities to the epidemiological situation of at-risk populations, as part of a regional effort. (R.A.)