Introduction Tuberculosis (TB) represents one of the main burdens for the global healthcare system. In 2022, the Ukraine had one of the highest TB incidences in Europe (90/100.000 population). It is to be feared that the Russian invasion in the Ukraine since February 2022 will result in a long-lasting increase in the incidence and mortality of TB, which will not only affect Russia and the Ukraine, but also the countries to which refugees have migrated. The German national centrum of disease-control and prevention (RKI) estimated that the incidence of TB in all Ukrainian refugees was between 0,02 % (20/100.000 population in children) and 0,06 % (60/100.000 population in men > 65 years) in all Ukraine refugees. Materials and Methods Since the start of the training of Ukrainian soldiers in Germany chest X-ray TB-screenings take place in the military hospitals in Berlin, Hamburg and Koblenz. The object of this study was to evaluate the aforementioned screenings in the light of resistance of M. tuberculosis, the administered therapy and the presence of comorbidities. Results The screening from November 2022 to May 2024 was analysed retrospectively. A total of 23 cases of active tuberculosis were identified in 13,620 soldiers during the course of this X-ray series examination (incidence 0,17). A resistance was identified in 23% (n = 6) of the positive cases. Discussion This screening and the resulting retrospective study are unique worldwide. In addition to the very high screening standard in a defined cohort, we carried out a molecular epidemiological analysis of the TB pathogens. This study shows the importance of TB in defence medicine and the burdens resulting from war. The proven incidence is substantially higher than expected by the WHO.