Interferon gamma (IFN-g) and interleukin 10 (IL-10) are believed to play opposing roles in host immunity against mycobacterial infection. IFN-g activates macrophages, while IL-10 downregulates the expression of T helper type 1 cytokines, MHC class II antigens and costimulatory molecules on macrophages. Associations of IFN-g À179 (G/T), þ 874 (A/T), þ 875 miscrosatellite CA repeats and þ 4766 (C/T), and IL-10 À1082 (A/G), À819 (C/T) and À592 (C/A) with tuberculosis (TB) were investigated in 385 HIV-negative patients and 451 controls in a Hong Kong Chinese population. The frequency of a low IFN-g-producing þ 874 A/A genotype was significantly over-represented in the patient group (Po0.001, OR ¼ 3.79, 95% CI ¼ 1.93-7.45). We identified 10 alleles in the IFN-g CA repeats and observed a significant difference in allele frequency distribution between patients and controls (Po0.001). By grouping alleles into 12 and non-12 CA repeats, the non-12/non-12 genotype yielded a similar significant result (Po0.001, OR ¼ 4.56, 95% CI ¼ 2.21-9.43) as observed in þ 874 A/A genotype. Weak associations of the IL-10 GCC/À genotype (P ¼ 0.04) and the low IFN-g-producing A/A genotype (P ¼ 0.06) with TB relapse/extrapulmonary cases were found. This study suggests the possible role of interferon gamma in TB susceptibility.