In the Republic of Tatarstan, in the period 2012 to 2021 we observed a twofold decrease in the incidence of tuberculosis: from 48 cases per 100 thousand population to 23.4 cases per 100 thousand population. However, there is an increase in the proportion of patients with respiratory tuberculosis in the decay and contamination phase, as well as fibrotic-cavernous and multiple drug-resistant forms of tuberculosis. It is important to analyze the epidemiological situation over a ten-year period, that will allow to develop or adjust measures for the prevention of tuberculosis in the Republic of Tatarstan. Objective: To establish patterns of manifestations of the epidemic process based on the indicators of the general incidence of tuberculosis in the Republic of Tatarstan for the period 2012-2021. Materials and methods: The study design is a descriptive epidemiological study. A retrospective epidemiological analysis of the incidence of general tuberculosis in the Republic of Tatarstan for 2012-2021 was carried out. The analysis of the long-term dynamics of the tuberculosis incidence in the population of the Republic of Tatarstan was carried out. Intensive indicators of morbidity in general, by contingents and ages were calculated. The structure of tuberculosis incidence in the Republic of Tatarstan was assessed, extensive morbidity rates in percentages (%) were calculated. Results: The long-term dynamics of annual morbidity rates of newly diagnosed tuberculosis in the Republic of Tatarstan in 2012-2021 is characterized by a statistically significant downward trend (р = -0,973 р < 0,001) at a rate of 7.8% per year. The indicated speed of the trend has reduced the incidence of newly diagnosed tuberculosis in 10 years from 48 cases per 100 thousand of population to 23.4 per 100 thousand of population, or twofold. Conclusion: Despite a significant decrease in the overall incidence of tuberculosis over a ten-year period, both in newly diagnosed patients and registered patients, in the Republic of Tatarstan the clinical structure of tuberculosis becomes more severe, namely, we experience an increase in the proportion of patients with respiratory tuberculosis in the phase of decay and contamination among newly diagnosed patients, with fibrous-cavernous tuberculosis among registered patients with multidrug-resistant tuberculosis.