Abstract The Foreign Workers’ Medical Examination Online Registration Portal or FOMEMA has been one of the key players in managing foreign workers wellbeing in Malaysia. Other than administering foreigninfluenced diseased risk from entering the Malaysian land, FOMEMA’s certification for fitness to work is one of the criteria for a Visit Pass (Temporary Employment) to be issued by Immigration Department of Malaysia. However, it is difficult to control a disease that easily spread around such as Tuberculosis. Since the world is currently facing the COVID-19 pandemic, the Government needs to be aware that the mechanism of Tuberculosis infection is somehow similar. In this paper, we discussed challenges in managing Tuberculosis threat among foreign workers and what contributes to the failure in FOMEMA Tuberculosis screening. A semi-structured interview and document analysis is used as data collection techniques. The study contributes to the existing knowledge pertaining to migrant workers and tuberculosis diseases, addressing three important issues; threat of tuberculosis disease prevalence among foreign workers to the public, precautionary actions to reduce disease transmission and challenges in repatriation of migrant workers.