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This study examines the consequences of stigmatization that occurred during a tuberculosis outbreak concentrated among Puerto Rican clients enrolled in a Chicago drug treatment center. Using ethnographic methods, I examine three factors that contributed to the stigmatization of those with TB. One factor concerns the fear elicited by the deadly disease that aroused reactions among Puerto Rican community members that were derived from earlier experiences. A second factor involves traditional public health measures enacted in response to the outbreak that facilitating labeling of those with TB, further fueling stigmatization. A third factor concerns the re‐articulation of group boundaries occurring among drug program inhabitants, whereby TB‐impacted persons were marginalized in order to reaffirmed the status of others whose identity had been compromised by the epidemic. The study’s implications for public health are discussed and suggestions are offered for developing innovative intervention approaches.