South Africa (SA) is one of the 30 high burden tuberculosis (TB) countries contributing 87% of the estimated incident TB cases worldwide, on its own SA accounts for 3% of cases globally. Among these 30 high burden TB countries, the country is among the 14 countries with the highest burden of TB, TB/HIV and multi-drug resistant TB (MDR-TB). The country’s TB epidemic is driven by a number of factors including low socio-economic status and a high HIV coinfection burden. Additionally, delayed health-seeking behaviour among individuals with TB, as well as a high burden of undiagnosed disease in communities also drive the TB epidemic. In August 2017 we commenced the first ever national TB prevalence survey, a survey that used Xpert MTB/RIF Ultra technology and liquid culture to test for TB among the adult population (≥ 15 years) in 110 clusters across South Africa. The Survey was conducted in line with international guidelines in accordance with the World Health Organization recommendations for conducting national TB prevalence surveys. This report represents a milestone in the history of TB management and research. It provides a precise estimate of the TB burden as well as health seeking behaviour of TB patients and those reporting TB symptoms.