Tuberculosis (TB) is still one of the top ten leading causes of death in the world. Compared to other Baltic and Eastern European countries, TB incidence (24.8 new cases per 100 000 people in 2017) in Latvia is relatively high. One of the regions with the highest TB incidence is Latgale (31.1 cases per 100 000 people). The aim of this pilot study was to identify markers of genetic predisposition to TB in Latgale. The study included 26 patients (16 males and 10 females) aged between 18 and 85 with bilateral TB pneumonia and without HIV infection. HLA typing was performed in HLA-DRB1, -DQA1, and -DQB1 loci by a polymerase chain reaction with low resolution sequence-specific primers. HLA-DRB1*07 and HLA-DRB1*11 alleles were identified as risk alleles for TB. HLA-DRB1*15 allele was a protective allele. Due to the limitations of this exploratory study, a broader study needs to be conducted to revealing specific risk and protective HLA Class II alleles for TB in the subpopulation of Latgale.