We performed a retrospective review of prospectively stored data on 545 children from 54 different birth countries with latent tuberculosis cared for in a pediatric tuberculosis clinic between August 1, 2005 and July 31, 2006. For analysis, patients were grouped into 6 geographic regions. The overall rate of completion of therapy was 54.4%. There were no significant differences among regions in the rate of completion of therapy by age, duration in the United States, or exposure to active tuberculosis. However, no children from Eastern Europe completed therapy compared with 67.9% from Central and South America. Of those children who did not complete therapy, parental refusal to start medication accounted for 54% and 80% of Eastern European and Asian children compared with <10% of children from Sub-Saharan Africa, Central and South America, and the United States.