An apparent increase in incidence of pulmonary and extrapulmonary forms of tuberculosis was observed in children in an inner-city community in New York City, New York USA. This occurred during years in which the case rates of tuberculosis declined in the city and the nation. Two unusual presentations of childhood tuberculosis are described. Physicians evidently should be more aware of the diagnosis of tuberculosis in children. Routine tuberculin skin testing with 5 of purified protein derivative (PPD) seemingly should be continued, with emphasis on testing in high-risk areas. Adequate funding of detection and treatment programs may prevent reemergence of this disease.