Study/Objective: The primary objective is to determine the clinical presentation of emergency department patients with Tuberculosis (TB) in southwestern Ontario, and to evaluate their pre-diagnosis emergency department utilization. Patterns and clinical findings will be used to develop a center-specific TB educational resource for ED physicians, to aid in the recognition and diagnosis of high risk patients which could be used at other large Canadian, urban tertiary care hospitals. Broadly, this study aims to increase awareness of TB in local EDs. Background: The Middlesex-London Health Unit (MLHU) reports on average 10 cases of active tuberculosis (TB) per year, with 99 cases between January 2005 and December 2015. Most patients with TB heavily utilize the emergency department (ED) prior to diagnosis. Patients with TB seeking care in the ED are often unrecognized as having TB, as risk factors and symptoms are frequently missed. Delays in diagnosis of TB worsen morbidity/mortality and increases disease transmission. The emergency department may present an opportunity for earlier diagnosis and intervention. To date, no studies have been undertaken to examine TB diagnosis and burden of care in Ontario EDs. Methods: A hospital-based retrospective review of adult and paediatric patients (n = 99) identified by Middlesex-London Health Unit as having active TB between January 1st 2005 and December 31st 2015 will be performed. Health records will be reviewed 1 year prior to and 6 months after the formal TB diagnosis to determine the clinical presentation of ED patients with TB. Results: This is a proposed study. Conclusion: This is a proposed study.