Since 1988, there has been a noted increase in the use of emergency transportation by tuberculosis patients in Japan. Therefore it is necessary to build a suitable emergency medical care system for these patients. We evaluated the present emergency medical care system available to them in Tokyo. We also studied emergency medical care service areas (MCSAs) to further aid in the revision of the emergency medical care system for tuberculosis. We used data from tuberculous patients who required the use of the emergency medical care system in Tokyo. The data was collected by the Tokyo Fire Department's emergency care information system from 1978 to 1990. We investigated and analyzed data regarding transportation and patient data. We also analized transportation data from the point of view of municipal districts (wards, cities, towns, villages), MCSAs and the Tokubetsuku region. We concluded that the number of emergency transports for tuberculosis patients has gradually been increasing and that the currently MCSA regions were not ideal for use in developing a transportation system for these patients. Using larger areas such as Tokubetsu-ku and Tokyotoka would be more practical emergency medical care system for tuberculosis patients in Tokyo, it will be necessary to take into account the Tokubetsu-ku area, the vagrant population within it, and the time required to transport the patients from this area to the Tokyotoka area.