Tuberculosis (TB) in South American camelids (SAC) is caused byMycobacterium bovis or Mycobacterium microti. Two serological methods, rapid testing (RT) and the dual-path platform (DPP) assay, were evaluated using naturally infected SAC. The study population included 156 alpacas and 175 llamas in Great Britain, Switzerland, and the United States. TB due to M. bovis (n ؍ 44) or M. microti (n ؍ 8) in 35 alpacas and 17 llamas was diagnosed by gross pathology examination and culture. Control animals were from herds with no TB history. The RT and the DPP assay showed sensitivities of 71% and 74%, respectively, for alpacas, while the sensitivity for llamas was 77% for both assays. The specificity of the DPP assay (98%) was higher than that of RT (94%) for llamas; the specificities of the two assays were identical (98%) for alpacas. When the two antibody tests were combined, the parallel-testing interpretation (applied when either assay produced a positive result) enhanced the sensitivities of antibody detection to 89% for alpacas and 88% for llamas but at the cost of lower specificities (97% and 93%, respectively), whereas the serial-testing interpretation (applied when both assays produced a positive result) maximized the specificity to 100% for both SAC species, although the sensitivities were 57% for alpacas and 65% for llamas. Over 95% of the animals with evidence of TB failed to produce skin test reactions, thus confirming concerns about the validity of this method for testing SAC. The findings suggest that serological assays may offer a more accurate and practical alternative for antemortem detection of camelid TB.Tuberculosis (TB) remains one of the most challenging and widespread zoonotic diseases in many countries (5,6,34). Mycobacterium tuberculosis and Mycobacterium bovis are the primary etiologic agents for human and bovine TB, respectively (8,30,39). M. bovis in particular is also known to cause TB in a broad range of domestic and wild mammal species (24,35). Infections with M. bovis have been shown to affect both New and Old World species of camelids (14,36,44,45). Tuberculosis in South American camelids (SAC), particularly in alpacas and llamas, has recently gained particular attention in Europe and in the United States, where these animals are being increasingly traded and kept in growing numbers as an alternative livestock industry (1). In recent years, M. bovis infections have been documented in alpaca and llama herds in parts of Europe, such as Great Britain (GB) (7, 37, 38), Ireland (32), and Spain (11), where this infection is endemic in cattle and wildlife. Also, SAC are known to be susceptible to M. microti, another member of the M. tuberculosis complex that can cause generalized disease with a fatal outcome in SAC (26,29,46). These infections are usually difficult to recognize in live animals because of the lack of reliable antemortem diagnostic tests and the nonspecific nature of the clinical signs of TB (4, 12). The intradermal tuberculin test is used in many countries, but that method is...