The characteristics of 149 patients with tuberculosis consecutively discharged from the Tuberculosis Service of the University of Tennessee Hospital in 1975 and 1976 were evaluated. The results of this study indicate the presence in this group of advanced age, alcohol abuse, debility from multiple chronic diseases, drug resistance, and recalcitrance. Despite the unfavorable circumstances surrounding these patients, 118 patients showed bacteriologic and/or roentgenographic evidence of improvement during an average of two to four months of hospitalization. We are not advocating the reversal of the present trend toward brief hospitalization and ambulatory care for the majority of tuberculous patients. However, as a result of this study, we believe hard-core patients of the type described in this paper require significant hospitalization for proper management.