During the first half of the 20th century, an epidemic of TB devastated Alaska’s indigenous people. Rates of death and morbidity due to TB in Alaska during that time were some of the highest ever reported anywhere in the world. An intense campaign by federal and territorial health providers and the availability of effective chemotherapy to cure and prevent TB disease led to a rapid decline of TB rates in the 1950s and 1960s. Despite these advances, Alaska continues to struggle with the ongoing legacy of this historical epidemic. In 2018, Alaska reported 63 cases of tuberculosis (TB) for an incidence of 8.5 cases per 100,000; the highest rate in the nation. TB in Alaska continues to be a public health challenge with notable health disparities. Effective treatment of active disease and latent TB infection (LTBI) is critical to ensure progress in prevention and control. Beyond the sustained work to cure active disease, the Alaska TB Program will work with statewide partners to emphasize targeted TB testing as an essential TB prevention and control strategy. We will work to identify, evaluate, and treat persons who are at high risk for LTBI or at high risk for developing TB disease once infected with M. tuberculosis and encourage shorter course treatment of LTBI (once active disease has been excluded). CDC funding is vital to supporting Alaska’s ongoing TB prevention and control activities, allowing enhanced testing, evaluation of contacts to active cases, prevention of disease transmission to uninfected persons, and preventing progression of latent tuberculosis infection (LTBI) to TB disease.