OBJECTIVES:  To determine the most cost-effective medical technology for diagnosing tuberculosis infection in the Russian Federation. METHODS:  As a part of a retrospective study, we created models for comparative evaluation of diagnostic techniques used for tuberculosis screening in children and adolescents (aged 1-17 years) in Moscow. The following were compared: Model 1 - the Mantoux test (data based on screening conducted in 2008 in 1,302,490 children and adolescents in Moscow); model 2 - the Mantoux test followed by recombinant tuberculosis allergen test in individuals with the positive Mantoux test reaction (data based on screening conducted in 2013 in 1,420,100 children and adolescents in Moscow); and model 3 – the stand-alone tuberculous recombinant allergen test (data based on screening conducted in 2015 in 108,729 children in Penza region). Cost calculations were based on price data from the State Register of Selling Price Limits, as well as the service cost data obtained from the Moscow Centre for Tuberculosis and No. 106 Polyclinics of St. Petersburg. RESULTS:  The effectiveness of the analysed diagnostic methods, expressed as the percentage of active tuberculosis infection among the screened individuals, was 0.006%, 0.012% and 0.019% for models 1, 2 and 3, respectively. Screening costs per 100 patients were €250.75, €220.43 and €200.16 for models 1,2 and 3, respectively (calculated based on the exchange rate announced by the National Bank of Russia on 16.06.2016). The cost-effectiveness ratios were 2,992,771.35, 1,359,327.53 and 779,574.74 for models 1, 2 and 3, respectively. CONCLUSIONS:  The recombinant tuberculosis allergen test is the most cost-effective tuberculosis screening method in children and adolescents, superior to the stand-alone Mantoux test or Mantoux test followed by recombinant tuberculosis allergen test.