The purpose of the present study is to investigate the performance of interferon γ release assay (IGRA) and tuberculin skin test (TST) in household contacts of tuberculosis patients, and to evaluate the predictive values of the two tests for disease progression from latent tuberculosis infection (LTBI) to active tuberculosis in China. Household contacts of active pulmonary tuberculosis patients were offered both IGRA (T­SPOT.TB) and TST, and then followed up for 6 years. The final cohort comprised 121 household contacts. T­SPOT.TB was positive in 49.6% of the contacts; the positive rate was associated with increasing age ﹝OR＝1.03 (95% CI 1.00­1.05)，P＝0.032﹞ and contacting with smear­positive patients ﹝OR＝2.13  (95% CI 1.01­4.51)，P＝0.048﹞. TST≥5 mm and TST≥10 mm accounted for 57.5% and 37.2% of the contacts, respectively. TST≥10 mm was positively associated with contacting with smear­positive patients ﹝OR＝2.30  (95% CI 1.05­5.06)，P＝0.038﹞. Seven cases progressed to tuberculosis within 626 person­years of follow­up, showing an overall incidence rate of 11.0 per 1 000 person­years. The positive predictive value (PPV) and negative predictive value (NPV) was 8.3% and 96.7% for T­SPOT.TB. The PPVs for TST≥5 mm and TST≥10 mm were 7.7% and 9.5% respectively; NPVs were both 95.8%. In conclusion, there is a high incidence rate of active tuberculosis among household contacts compared to general population in China. The predictive values of IGRA and TST for progression to active tuberculosis among household contacts are comparable.