Introduction. In the context of a decrease in the intensity of the epidemic situation of tuberculosis In Russia, the search for new ways to increase the effectiveness of preventive measures to combat tuberculosis among the adult population remains relevant. Aim. To study the prevalence of latent tuberculosis infection in adult tuberculosis risk groups, and to conduct a comparative assessment of the effectiveness of detecting active tuberculosis by immunodiagnostics and fluorography among adults at risk of tuberculosis. Mat erials and methods. In a retrospective study, the results of a survey of people at risk of developing tuberculosis over the age of 18 with a positive test result from ATR-test were analyzed. At the first stage, the prevalence of latent tuberculosis infection was studied. At the second stage, a comparative analysis of the detectability of active tuberculosis during immunodiagnostics and during preventive fluorographic studies was carried out. Results. It was found that among adults at risk of tuberculosis, the prevalence of latent tuberculosis infection in the medical risk group was 2.7 times higher, and in the social risk group it was 8.7 times higher than the average in the population. The detection rate of active tuberculosis according to the results of immunodiagnostics was the highest in the social risk group – 3.8 cases per 1,000 examined. In terms of the effectiveness of tuberculosis detection in adults at risk of tuberculosis, immunodiagnostics is comparable to fluorographic studies (0.19 and 0.17 per 1,000 at-risk subjects, respectively). Conclusions. Conducting annual immunodiagnostics among adults at risk of tuberculosis allows timely detection of latent tuberculosis infection, and also increases the effectiveness of early detection of active tuberculosis, which helps reduce the reservoir of tuberculosis infection.