The proportion of tuberculosis (TB) patients in the European Union (EU) who die remains high (8% overall). The aim of the present study was to quantify the risk of dying associated with demographic and clinical factors. Case-based data on 39,566 TB patients notified by 15 EU countries during 2002-2004 were analysed using logistic regression. It was observed that advancing age and resistance to isoniazid and rifampicin were the strongest determinants of death, while male sex, European origin, pulmonary site of disease and previous anti-TB treatment were weaker predictors. Risk varied between reporting countries, presumably reflecting differences in patient profiles, reporting practices and programme effectiveness. In conclusion, earlier suspicion, diagnosis and treatment may reduce deaths, particularly among the elderly. Special attention is needed to avert the development and transmission of multidrug-resistant tuberculosis.