Converging factors contribute to elevated tuberculosis (TB) incidence and complicate case management in the U.S. states bordering Mexico. These factors include a) Mexico's higher TB rate; b) low socioeconomic status and limited access to health care in the border area; c) frequent border crossings and travel in the United States for employment, commerce, health services, and leisure; d) language and sociocultural differences; and e) lack of coordinated care across health jurisdictions on both sides of the U.S.-Mexico border. Prevention and control efforts that address the challenges created by border-crossing populations require collaboration among local, state, and national TB control programs in both countries. In June 1999, to facilitate future discussions with Mexican counterparts, CDC convened a meeting of TB control officials from the four U.S. states bordering Mexico (i.e., California, Arizona, New Mexico, and Texas) to address TB prevention and control in the border area. Focus areas included a) surveillance needs, b) case management and therapy completion, c) performance indicators and program evaluation, and d) research needs. Meeting participants' deliberations and resulting proposals for action by CDC and state and local TB control programs are detailed in this report.