This chapter begins with an overview of the pathogenesis of TB in patients with chronic renal failure. The burden of Tb in patients with chronic renal failure is then described. Clinical presentation of TB in patients with chronic renal failure receiving maintenance hemodialysis and renal transplant recipients as documented in various published studies are presented in exhaustive detail. The diagnostic work-up and treatment are discussed then. Antituberculosis drug dosage modification is also clarified. Treatment of latent TB infection in patients with renal failure, nontuberculous mycobacterial infections are also dealt with.