Introduction – Seine-Saint-Denis has the highest incidence rate of tuberculosis in mainland France. Case investigations are conducted by the Center for Tuberculosis Control (CLAT), which is affiliated with the Departmental Council. The onset of the COVID-19 pandemic has impacted the epidemiology of tuberculosis, as well as the conduct of case investigations.Method – A retrospective descriptive analysis, covering two-year periods between 2018 and 2023, of the Clat’s activity in Seine-Saint-Denis was conducted, including an analysis of index tuberculosis cases, contacts, and investigations carried out.Results – Seine-Saint-Denis did not experience a decrease in the number of active tuberculosis cases during the COVID-19 pandemic, with 832 cases in 2018–2019 and 851 cases in 2020–2021. At the same time, the number of identified contacts decreased sharply, from 6,379 to 3,782. Despite this reduction, screening among contacts was carried out, with screening rates remaining stable, which allowed for consistent detection of secondary cases. Thus, 1,423 latent tuberculosis infections (13%) and 135 secondary tuberculosis cases (1%) were diagnosed among 11,215 contacts screened between 2018 and 2023. The characteristics of index cases have changed, within a population that remains largely in precarious circumstances. The types of links between index cases and their contacts have also changed. Discussion – Tuberculosis control efforts during the COVID-19 period in Seine-Saint-Denis were marked by a stable number of tuberculosis cases, contrary to the national trend. A reduction in the number of contacts was observed, but screening efforts were maintained.