More than 50 years ago, Comstock and colleagues demonstrated among Inuit communities in Alaska that mass testing and treatment of latent tuberculosis infection (LTBI) could achieve the levels of decline in tuberculosis (TB) incidence required for elimination. With the renewed emphasis on TB elimination globally and in the United States, there is increasing momentum for scale-up of LTBI testing and treatment. This symposium will explore the following: impact and cost-effectiveness of scale-up; how current tests and treatment regimens should be utilized; novel approaches in the pipeline to further improve testing and treatment; and gaps in implementation of LTBI testing and treatment.