In France, as in most Western European countries, the incidence of tuberculosis is higher in large cities, which are more affected by population movements and by people in situations of economic and social vulnerability. The objective of this study is to describe changes in the incidence rate of tuberculosis between 2000 and 2010 in the various departments of the Île-de-France region, as well as the sociodemographic characteristics of the cases. Over the study period, the tuberculosis case rate declined sharply through 2006, falling from 28.6 cases per 105 inhabitants (inh) to 17.1 cases per 105 inh, and then more gradually to reach 16.2 cases per 105 inh in 2010. The highest reported rates were observed in Seine-Saint-Denis, where the incidence has been stable since 2002, and in Paris. The proportion of cases born in France decreased over the entire period, while that of cases born in a European country increased. The proportion of cases born in a sub-Saharan African country was high. Among the cases, 5% were homeless individuals, with this proportion being higher in Paris (10%). The incidence rate of tuberculosis is generally declining in the region, except in the department of Seine-Saint-Denis, where the rate has remained stable since 2002. The region is characterized by significant disparities among departments. (R.A.)