Objective — to clarify the peculiarities of the course of extrapulmonary tuberculosis to improve its diagnosis by studying the trend of this form of tuberculosis in Sumy region.
 Materials and methods. The structure of the incidence of extrapulmonary tuberculosis of the Sumy region among residents during 2004—2020 was analyzed.
 Results and discussion. During the period from 2004 to 2020, 1414 new cases of extrapulmonary tuberculosis were registered in the region. The largest number of patients with this form of tuberculosis — 142 (24.3 %) was registered in 2004. The lowest — in 2020 — 33 (9.8 %) patients, ie decreased by 2.5 times. In the study period in Sumy in 2020, 3.1 patients per 100,000 population were diagnosed with extrapulmonary tuberculosis, which is almost 3 times less than in 2004 (11.3 patients per 100,000 population). 68 % of cases were registered in children. Among children with extrapulmonary tuberculosis, the incidence ranged from 13 cases per 100,000 children in 2004 to 0.7 per 100,000 in 2020. At the same time, the decrease in the incidence of extrapulmonary tuberculosis occurred with a sharp decrease to 0.7 per 100,000 in 2013—2014 and increase to 4.8 per 2015 and 7.0 per 100,000 children in 2016. And in 2020 again a sharp drop to 0.7 per 100,000 children. Compared to 2019, when the incidence of extrapulmonary tuberculosis was 6.3 per 100,000 children, this figure decreased by 9 times. The reduction in the number of BCG vaccinations in the region during the study period more than 2 times (in 2004 — 14,564 vaccinations, and in 2019 — 6,154) has an impact on changing the incidence of extrapulmonary tuberculosis among children.
 Conclusions. The number of patients with extrapulmonary tuberculosis decreased 3.6 times during 2004—2020: from 11.3 to 3.1 patients per 100,000 population. Extrapulmonary forms of tuberculosis predominated in children (68 %). The incidence of such forms of tuberculosis at the age of 0—14 years during 2004—2020 decreased from 13 to 0.7 cases per 100,000.Extrapulmonary tuberculosis of the respiratory organs accounted for 57.4 %, tuberculosis of the bones and joints — 21.6 %, tuberculosis of the genitourinary system — 15.1 %.The incidence of osteoarticular tuberculosis in children (30.6 %) exceeded the corresponding figure in adults (21.1 %) and was 2.6 higher than the corresponding figure in Ukraine (11.7 %). Detection of peripheral lymph node tuberculosis in children of Sumy region (0.7 %) was significantly lower than in Ukraine (7.3 %).In adolescents, extrapulmonary respiratory tuberculosis significantly prevailed between all localizations — 82.2 %. The incidence of tuberculosis of bones and joints was 4.4 %, which is 4.8 times less than in adults and 7 times less than in children. The last indicator in Sumy region was 2 times less than the corresponding indicator in Ukraine (9.0 %).