Recurrent tuberculosis (TB) outbreaks in the North point to the need for a change in the management of this disease. We propose to use a PRECEDE-PROCEED inspired framework to identify three different levels of factors that have contributed to the ongoing TB outbreak in Qikiqtarjuaq, Nunavut. The main predisposing factor discussed is the sustained impact of colonialism, due to the Inuit community’s historical experiences with TB eradication efforts led by the Canadian government. Enabling factors that prevent a sustained reduction in the prevalence of TB include inadequate housing and sanitation infrastructure; food insecurity and malnutrition; and a lack of access to healthcare services. Lastly, reinforcing factors including stigma and fear surrounding TB act to sustain the impact of the underlying factors. Addressing these multi-level causes via governmental interventions will contribute to gains in the fight against TB in Inuit communities.