Tuberculosis (TB) is a serious health threat to migrant farm workers in the Midwestern United States. This article describes characteristics of migrant culture and lifestyle, economic, and health challenges that may impact screening, diagnosis, and adherence with complex medication regimens associated with TB. A brief overview of TB discusses the historical perspective of the disease and describes the stages, transmission, and incidence among migrant populations. Several theoretical models, such as the Health Belief Model (HBM) and social cognitive theory, were considered by the authors to guide understanding of migrant beliefs about TB. A qualitative research study conducted with 23 Hispanic migrants with latent TB infection is presented. Discussion of the research findings describes environmental, cognitive, and social factors that were barriers to screening, diagnosis, and treatment. The article concludes with a description of recent migrant health clinic updates designed to improve the worker' health status and considerations for environmental and educational change.