Abstract Tuberculosis (TB) prevention and control in schools is always the key area of TB control work. The paper reviews the TB epidemic change trend and characteristic in students, and analyzes existing problems in current TB control work in schools, including incompletely implemented routine precaution measurements in schools, inaccurate occupational information for TB patients, absence of evidence from TB laboratory in diagnosis and tracing infectious source, lack of timeliness and standardization in close contact screening, low coverage of preventive therapy, and lack of capacity for tackling public sentiment. Specific suggestions were proposed for every institute involved in TB control work in schools to solve these problems.