James R, et al. – Alternative active case finding (ACF) implementation models for tuberculosis (TB) were being introduced in numerous resource–constraint settings. Researchers here aimed at gaining evidence on relative cost–effectiveness, which is essential to inform resource allocation decisions of national policy makers, is lacking. A novel, pragmatic methodological approach was applied to compare the cost–effectiveness of three ACF implementation models that had been implemented between 2012 and 2013 in Cambodia, allowing the models to be ranked in terms of potential to identify the largest number of new bacteriologically–positive TB cases per unit of investment. Observations revealed that implementation of ACF activities in urban areas was slightly more cost–effective than in rural areas, and that the pragmatic cost–effectiveness assessment approach provided information that was called for by local policy makers.