The author analyses the factors which brought about the rapid decline of tuberculosis in Japan during the past 30 years. Among the modern measures combating tuberculosis, chemotherapy and the extensive use of BCG vaccination are at the paramount place. As a result of intensive control the problem of tuberculosis has become smaller and smaller and a turning point is reached. The future direction of tuberculosis control is determined by chemoprophylaxis of high risk groups and by symptomatic casefinding combined with selective mass miniature radiography for high risk groups using high technical standards. By means of intensive initial chemotherapy the duration of treatment will be shortened. In 1974 the policy of BCG vaccination was changed; primary vaccination is provided for children in the age of 0 to 3 years, and revaccination at entrance to primary school and in leavers from middle school for tuberculin non-reactors. If the annual risk of infection will continue to decline the primary vaccination age it intended to be raised up to school entrance.