In recent years, the transmission of tuberculosis in health care facilities ( nosocomial transmission) has reached epidemic proportions. These transmissions have included outbreaks of multidrug-resistant strains of Mycrobacterium tuberculosis that have produced many deaths. Preventing transmission of TB in health care facilies requires a comprehensive program including effective indentification, isolation, and treatment of infected persons, specific ventilation, general ventilation, personal respiratory protection and surveillance of health care workers. Epidemiology, transmission and pathogenesis of TB are discussed to provide a framework for understanding the disease. The engineering aspects of hospital facility design related to controlling TB are outlined including general and specific ventilation, air filtration, ultraviolet germicidal irradiation, isolation suite design and room pressure control strategies. For engineers and other professionals not directly related to the medical profession, definitions are included as an appendix to familiarize the reader with the terminology found in the extensive references.