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Injection drug use (IDU) has important criminal and public health implication in the Republic of Moldova. IDUs are key population for HIV and have a high risk for TB. The aim was to assess the risk factos for TB at IDU patients. Methodology:restrospective cohort study of 48 IDUs with TB (1stG) were compared with 185 TB cases without history of drug use (2ndG). Results: male/female ratio=7/1 in 1stG vs 2,9/1 in 2ndG. Between 25-44 y.o. were 47(98%) in 1stG vs 88(47%) in 2ndG, unemployed 43(90%) vs 124(67%), disabled 3 (6%) vs 14(8%), had no health insurance 40(83%) vs 135(75%), homeless were 8(17%) vs 29(16%), ex-deteines were 16(33%) vs 2(1%), close TB contact had 15(31%) vs 15(8). Comorbidities: HIV+ were 21(43%) vs 11(6%), chronic alcoholism 3(6%) vs 13(7%), viral hepatitis 2(4%) vs 2(1%), psychiatric diseases 1(2%) vs 4(2%). By active screening were detected 9(19%) vs 35(19%) and passively were detected 39(81%) vs 150(81%) cases. Pulmonary TB was diagnosed in 37(77%) vs 170(92%) and disseminated TB in 7(15%) vs 15(8%) cases. AFB smear was (+) at 17(35%) vs 55(30%), conventional cultures were (+) at 22(46%) vs 62(33%) cases. Successfully treated were 21(44%) vs 158(85%), were lost to follow-up 10(21%) vs 2(1%), died 8(17%) vs 11(6%), were continuing treatment for MDR-TB 8(17%) vs 12(6%) cases. Risk factors for TB at IDUs were middle adulthood OR=3(CI95% 1,2-7,8), unemployment OR=6(CI95% 1,9-19), uninsuranced state OR=3(CI95% 1,1-9), homelessness OR=5,7(CI95% 1,7-43,2), HIV infection OR=27(3,2-203). Conclusion: social vulnerable and comordid IDUs have high risk for TB. They should be screened annually and have an individualized approach for preventing low treatment outcome.