Kendall et al discuss the epidemiological importance of subclinical tuberculosis (TB). The World Health Organization has adopted ambitious targets to end the TB epidemic, including a 90% reduction in incidence from 2015 to 2035. The corresponding End TB Strategy focuses on the early diagnosis and treatment of individuals with recognizable symptoms and treatment of latent TB infection in people at high risk. However, these targets may not be achievable without increased attention to averting transmission from the millions of people who have subclinical TB. Historically, TB has been conceptualized by some as consisting of latent infection (asymptomatic and noninfectious) and active disease (symptomatic and infectious).