The tuberculosis death rate in forty-six large American cities having a total population of 31,715,186 has declined from 62.0 in 1938 to 59.4 in 1939 per hundred thousand of population. There is not only a decline in the rate but an absolute decline in the number of deaths from 19,509 in 1938 to 18,799 in 1939. The variation between cities is striking. Akron, Ohio, and Minneapolis have rates of 26 and 31 respectively. Detroit with 58 and Toledo with 60 are representative of the average for the United States, while Memphis with 103 and San Antonio, Texas, with 153 are at the other extreme. While Negroes make up but a little over 10 per cent of the population, they suffered 32 per cent of the deaths, in contrast with 68 per cent for white persons, who constitute almost 90 per cent of the population.