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Care cascades represent the proportion of people reaching milestones in care for a disease and are widely used to track progress towards global targets for HIV and other diseases. Despite recent progress in estimating care cascades for tuberculosis (TB) disease, they have not been routinely applied at national and subnational levels, representing a lost opportunity for public health impact. As researchers who have estimated TB care cascades in high-incidence countries (India, Madagascar, Nigeria, Peru, South Africa, and Zambia), we describe the utility of care cascades and identify measurement challenges, including the lack of population-based disease burden data and electronic data capture, the under-reporting of people with TB navigating fragmented and privatised health systems, the heterogeneity of TB tests, and the lack of post-treatment follow-up. We outline an agenda for rectifying these gaps and argue that improving care cascade measurement is crucial to enhancing people-centred care and achieving the End TB goals., Competing Interests: Declaration of interests MP serves on the Scientific Advisory Committee of the Foundation of Innovative New Diagnostics (FIND), a non-profit global alliance for diagnostics. MP is also an adviser to the Bill & Melinda Gates Foundation. He has no financial or industry conflicts. CU-G has received research support from the International Development Research Centre (Canada) and the Canadian Institutes of Health Research, the National Institutes of Health, FIND, and Abbott for projects unrelated to this work. CU-G has also received honoraria from Molbio for presentations unrelated to this work. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)