The situation in France regarding tuberculosis has been characterized by a steady decline in reported cases over the past several decades. However, national data mask a heterogeneous situation marked by significant disparities. Based on mandatory reporting data, we briefly describe the main epidemiological characteristics of active tuberculosis in France in 2018, and focus on the regions and groups most affected. In 2018, 5,092 cases of active tuberculosis were reported, representing a reporting rate of 7.6 cases per 100,000 inhabitants. The highest reporting rates were observed in French Guiana (25.7/100,000), Île-de-France (16.1/100,000), and Mayotte (11.5/100,000). The reporting rate was nearly 17 times higher among people born abroad than among those born in France (40.1 per 100,000 and 2.4 per 100,000, respectively). The case rate was 249 per 100,000 among the homeless population and 76.0 per 100,000 among prisoners. Despite the overall improvement in the epidemiological situation of tuberculosis in France, the high incidence rates in certain regions and population groups require continued control efforts and the utmost vigilance. Measures must be adapted to account for specific epidemiological situations in order to achieve the goal of eliminating tuberculosis in France and Europe.