Solid organ transplant (SOT) recipients have a significantly increased risk of developing infection with Mycobacterium tuberculosis compared with the general population. In a large Spanish cohort (RESITRA), the incidence of tuberculosis (TB) was 27-fold higher in SOT recipients than in the general population. It is difficult to recognize active TB in SOT recipients, since symptoms are often attenuated and the clinical presentations atypical. In a French multicenter retrospective cohort, 31% of all active TB cases after kidney transplantation (KT) were disseminated or 67% occurred at extra-pulmonary sites, compared to only about 20% of cases in normal hosts. Impediments to rapid and accurate diagnosis may lead to treatment delay. Therefore screening for latent tuberculosis infection (LTBI) in SOT candidates is important to prevent active TB diseases after transplantation.