BACKGROUND: Occupational tuberculosis (TB) in hospital-based health care workers is reported regularly, but TB in community-based health care researchers has not often been addressed. OBJECTIVE: To investigate TB incidence in health care researchers in a high TB and human immunodeficiency virus prevalent setting in the Western Cape, South Africa. The health care researchers were employed at the Desmond Tutu TB Centre, Stellenbosch University. METHODS: A retrospective analysis was performed of routine information concerning employees at the Desmond Tutu TB Centre. The Centre has office-based and community-based employees. RESULTS: Of 180 researchers included in the analysis, 11 TB cases were identified over 250.4 person-years (py) of follow-up. All cases were identified among community-based researchers. TB incidence was 4.39 per 100 py (95%CI 2.45-7.93). The standardised TB morbidity ratio was 2.47 (95%CI 1.25-4.32), which exceeded the standard population rate by 147%. CONCLUSIONS: TB incidence in South Africa was 948 per 100,000 population per year in 2007; in the communities where the researchers worked, it was 1875/100,000. Community-based researchers in the study population have a 2.34 times higher TB incidence than the community. It is the responsibility of principal investigators to implement occupational health and infection control guidelines to protect researchers.