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The association of tuberculosis (TB) with poverty has long been recognized, yet it may reflect not only characteristics of poor individuals, but also housing and neighborhood features which promote airborne spread. We sought to determine whether dwelling and building features, residential density and crowding are independently associated with TB occurrence in a low-incidence setting. We used residential addresses to geocode active TB cases reported in Montreal in 1996–2000. These “case dwellings” were linked to the municipal dwelling geodatabase from 2000, and to Canadian census data from 1996. We compared them with randomly selected Montreal dwellings (“controls,” in a 1:10 ratio), using the same data sources. From multivariate logistic regression, the 595 case dwellings were more likely than the 5950 control dwellings to be in buildings >5 stories tall (adjusted odds ratios [OR] 1.6; 95% CI: 1.0–2.5 …