The objective of this study is to describe the epidemiology of tuberculosis in Seine-Saint-Denis, taking into account the region’s unique demographic and socioeconomic context. Between 2013 and 2018, 2,482 cases of tuberculosis were reported in Seine-Saint-Denis, with the incidence rate peaking at 27.8 per 100,000 inhabitants in 2014. This department continues to have a higher rate than the rest of metropolitan France (7.3 per 100,000 inhabitants on average) and remains relatively stable. The poverty rate and the incidence of tuberculosis were correlated at all levels (intra-departmental, regional, national), but Seine-Saint-Denis stood out from other metropolitan departments due to its extreme values. Furthermore, a socioeconomic typology of the municipalities showed a remarkably overlapping distribution of social deprivation indicators with the map of tuberculosis incidence rates; the proportion of foreign residents and the share of residents reporting difficult living conditions were associated with a higher incidence of tuberculosis. The specific social situation in Seine-Saint-Denis could therefore contribute to this tuberculosis incidence, which remains high in a country with low endemicity. The dual challenge of addressing the epidemiological situation and reducing territorial and social inequalities thus calls for a strong level of commitment from public authorities.