The Xpert MTB/Ultra molecular diagnostic test for stool samples, until now recommended only for children, could be established as an additional test for diagnosing tuberculosis in adults living with HIV. This is the main conclusion of the Stool4TB Alliance study, led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by the “la Caixa” Foundation, in collaboration with the Manhiça Health Research Centre (CISM), the Research Center Borstel, the Makerere University, the Baylor College of Medicine Children’s Foundation — Eswatini, and The Amsterdam Institute for Global Health and Development. The results, published in The Lancet Microbe, could represent a paradigm shift in the diagnosis of the disease in this population.