In France, the incidence of tuberculosis has remained stable at around 10 cases per 100,000 inhabitants since 1997. However, the Île-de-France region, which has the highest population density and the largest number of people living in precarious conditions, accounts for more than half of all reported cases in France. A retrospective descriptive study based on mandatory reporting data for the year 2001. The incidence of tuberculosis was 27.2 cases per 100,000 inhabitants in 2001 in the Île-de-France region and 48.4 per 100,000 inhabitants in Paris. The most affected individuals were young people of foreign nationality, particularly from sub-Saharan African countries. Pulmonary forms were predominant, affecting 72% of cases. HIV co-infection was documented in 7.5% of cases. A request for intervention by tuberculosis control services was made in fewer than 30% of cases, and for only 50% of cases living in group settings with pulmonary disease. Epidemiological surveillance and tuberculosis control efforts need to be strengthened in the Île-de-France region, particularly through the mobilization of all stakeholders to improve the responsiveness and effectiveness of the system. (R.A.)