Tuberculosis (TB) is the most common infectious disease in the world, with more than 1.2 million new pediatric cases and 210,000 deaths in children annually (Global Tuberculosis Report 2023. World Health Organization, Geneva, 2023). Over two billion people are infected with Mycobacterium tuberculosis, and it is a leading cause of mortality in persons of reproductive age, killing half a million women around the world in 2013 (Malhamé et al., PLoS One. 11: e0154825, 2016). Although TB infection and disease are very common, perinatally acquired infection and disease are rare and incompletely understood. Perinatally transmitted TB can be acquired vertically during the intrauterine period (congenital TB) or shortly after birth (postnatal) through exposure to someone with contagious pulmonary disease. Differentiating congenital and postnatally acquired TB is only important from an epidemiological standpoint as their clinical presentations, management, and prognosis are indistinguishable. Distinguishing TB infection from disease is important in determining management. If a person has a positive tuberculin skin test (TST) or interferon-gamma release assay (IGRA) with a normal CXR and is asymptomatic, they are considered to have TB infection. A person who has a positive TST or IGRA with an abnormal CXR or symptoms consistent with TB such as fever, cough, or weight loss is considered to have TB disease.