A large study reported that pooled sputum testing using up to four samples in a single Xpert MTB/RIF Ultra cartridge can halve TB diagnostic costs while expanding rapid testing reach. The largest-ever pooled approach is designed to reduce per-test costs for programs dealing with “missed millions” who remain undiagnosed, especially where laboratory capacity and funding constrain testing. For TB control stakeholders, the findings provide an operational pathway to scale molecular diagnostics without proportional increases in cartridges. The study’s impact will likely depend on local implementation details—sample pooling workflows and quality assurance in routine settings.