Tuberculosis (TB) continues to be a serious health issue for some Aboriginal populations in Canada. In this article we build on two previous studies partnered with an Aboriginal community organization to examine TB in Montreal, Quebec. The current study draws on qualitative interviews with Aboriginal participants who had either themselves contracted TB or knew someone who had the disease. Thematic analysis revealed a high level of experiential knowledge among participants, although gaps in biomedical knowledge about the disease and available resources were apparent even among those who had been ill. Negative memories and experiences relating to the colonial history of TB treatment emerged as significant for many participants, helping to explain a silence around the topic of TB in the community. Barriers to TB testing were identified, including the fear of positive test results, the burden of long-term treatment for either latent or active disease, and systemic barriers within and mistrust of the health system. Community support for, as well as negative reactions toward, individuals ill with TB were identified. We conclude with a number of community health lessons to address the treatment and prevention of TB in urban populations.