Of the 411 patients notified with tuberculosis in Leeds during 1986 through 1991, case notes were available on 406 (99%) and the diagnosis of mycobacterial disease was accepted in 397 (98%). Twenty-two patients had infection with atypical mycobacteria and were excluded from analysis, as were children under 16 years. Comparison between the age groups was further restricted to white patients because of a skew distribution of Asian patients towards the younger age range. Ninety-six elderly patients (aged 65 years and older) were compared with 127 younger patients. The distribution of pulmonary and extrathoracic disease was similar as was the incidence of positive bacteriology. Elderly people had more frequent lower-zone and more frequent miliary shadowing, otherwise radiographic features were similar. Elderly people were nearly three times more likely to have reactions to antituberculous drugs, six times more likely to die from tuberculosis and over twenty times more likely than younger patients to have the diagnosis made at autopsy rather than during life.