Abstract: Objective To understand the cost-benefit of tuberculosis (TB) prevention and control in Karamay, Xinjiang autonomous region, from 2001 to 2015. Methods The quarter and annual reports of TB surveillance from prefecture to district levels during this period were collected, and analyzed according to The Final Evaluation Protocol for National Tuberculosis Control Program in China. Results The government and international organization invested 5.915 4 million yuan (RMB) for TB prevention and control in Karamay from 2001 to 2015. A total of 2 340 active pulmonary TB cases were detected, and 1 127 smear positive patients, 1 088 smear negative patients and 2 215 active TB patients were cured. A total of 587 deaths due to TB, 9 852 infections of Mycobacterium tuberculosis and 986 TB cases were prevented. The medical cost was reduced by 751 100 yuan (RMB), and 1.4 277 658 billion yuan (RMB) economic and social losses were avoided. The cost-utility ratio was 414.84. The benefit-cost ratio was 241.49. Conclusion Taking comprehensive TB prevention and control measures has achieved high case finding rate and cure rate of TB in Karamay, resulting remarkable social and economic benefits.