Although the overall incidence and prevalence of tuberculosis (TB) is relatively low in the United States, the disease remains a significant problem among certain populations. Refugees and immigrants migrating from endemic countries are especially at risk for TB, and in Minnesota the majority of cases are found in this population. Given that the vast majority of these cases are caused by reactivated latent infection rather than primary infection, the key to disease control and prevention is the successful diagnosis and management of latent TB in immigrants and refugees from endemic areas. This article details the appropriate approach to screening, diagnosis and management of latent TB in the hope that all physicians are better equipped to aid our state's foreign-born population and improve public health.