An analysis of the TB situation in three Siberian territories, i.e. the Kemerovo, Omsk and Tomsk Regions, is presented. Conclusions pertaining to the key specific features were made and a correlation between an epidemic level tension, on the one hand, and an efficiency of the anti-TB activity management, on the other hand, was established. The conclusions were considered as a precondition for setting up a management structure in the sphere of the anti-TB activity that would accumulate the achievements of home phthisiology and of modern methodological and methodical management approaches. Results of elaborations of Novosibirsk Research Institute of TB Issues, which are related with establishing an anti-TB management system in Siberia, are presented; such system would comprise aims, functions, a structure and the key management components. Supposedly, the described approach is expected to optimize the efficiency and good results in the anti-TB management activity at all levels with the resources being distributed and used on the rational basis.