This archive-based study investigates tuberculosis policy in the German Democratic Republic (GDR) from the 1940s to the 1960s. The focus is on the sanatorium as the major site of treatment and on BCG vaccination as the major preventive tool. The article tests and accepts the thesis that the GDR’s guiding health paradigm is best described by the term “medicalized social hygiene.” The article finds that methods of both treatment and prevention were characterized less by radical change and innovation than by tradition and pragmatism at least until the mid-1950s. Thus, “forced institutionalization” of “asocial” patients continued after 1945. Yet the health ministry long hesitated to make BCG vaccination obligatory. The German past, the Cold War context of German–German rivalry, and medical and popular attitudes toward vaccination, TB, and TB patients are considered as possible explanations for the mix of continuity and change in TB policy.