In 2004, 414,163 cases of tuberculosis were reported in Europe (51 countries), 70% of which were from Eastern European countries (former Soviet Union). The significant burden of tuberculosis and high resistance rates in Eastern Europe are a major concern. In contrast, in most Western European countries, the trend is downward, with cases of foreign origin increasing significantly. Tuberculosis control in Europe must be strengthened and adapted to the various epidemiological profiles identified through surveillance. (R.A.)