Introduction. Recently, there have been more and more publications in the literature indicating the need to move from a continuous fluorographic examination of the population to a differentiated examination of high-risk groups for tuberculosis, which make up 25% of the population and among whom the probability of developing the disease remains the highest. Objective: to study the dynamics and effectiveness of tuberculosis detection in the Kaluga Region in 2014-2023. Materials and methods. The indicators of population coverage with tuberculosis examinations by all methods and population coverage with tuberculosis examinations by fluorography, as well as the indicators of tuberculosis detection by all methods and fluorography, were analyzed. Then, the structure of newly diagnosed patients with TB in the Kaluga Region in 2014–2023 was analyzed. Results. In the Kaluga Region, for the period from 2014 to 2023, the incidence of TB decreased by 3.7 times and in 2023 amounted to 16.6 per 100 thousand population, but this did not lead to a decrease in the effectiveness of mass examinations, including using the FG method. Despite the high coverage of the region's population with examinations, which amounted to 65.3% in 2023, the values of the TB detection rate for the period from 2014 to 2023. decreased by 4.3 times and in 2023 amounted to 0.12 per 1 thousand examined persons. Despite the decrease in the number of identified patients with TB, their structure still includes a high proportion of those who were identified late when contacting medical organizations providing primary health care with clinical manifestations of TB, and those who were diagnosed with TB posthumously. Conclusion. Such dynamics indicated that examinations often cover the same groups of the population every year, while other groups of the population, including those with an increased risk of TB, remain outside the field of view of medical organizations providing primary health care and responsible for conducting examinations.