An ecological study was conducted to estimate the burden of incident tuberculosis attributable to diabetes in the Region of the Americas. Population size, the prevalence of diabetes, and the incidence of tuberculosis (TB) in the adult population of each country in 2013 were used to estimate the percent population attributable risk. The estimated population attributable risk was 16.8% (CI 95%: 10.8-23.8%), which corresponds to 25,045 (16,050-35,741) incident cases of TB per year. Diabetes is an important determinant of the incidence of tuberculosis in the countries of the Region of the Americas and may account for up to 1 in 4 incident TB cases. For countries, the intersection of both epidemics poses the dual challenge of providing integrated are and control of comorbidity and its structural social determinants.