Serum IgG and IgM antibodies against a 2,3-diacyl-trehalose-2'-sulphate (SL-IV) antigen using ELISA were determined in controls (n = 288) and in leprosy (n = 210) and tuberculosis (n = 99) patients. In all assays, the amount of antigen per well was 100.0 ng and sera were diluted 1/250. In the case of leprosy, anti-SL-IV IgG and IgM antibody titres increased from the tuberculoid towards the lepromatous pole of the spectrum. In the tested population, the sensitivity of the assay was 93.2% in multibacillary leprosy and 33.3% in paucibacillary leprosy (specificity of 88.7%). Multibacillary patients with erythema nodosum leprosum (ENL) had lower titres than non-ENL. ELISA results were similar to those obtained using the Mycobacterium leprae phenolic glycolipid-I (PGL-I) antigen. In the case of tuberculosis (pulmonary and extrapulmonary), significant titres of anti SL-IV IgG and IgM antibodies were detected in about 75% of the patients using a cutoff point of 0.150, and in 51.6% using a cutoff of 0.300 (specificities were, respectively, 88% and 100%). We concluded that the determination of IgG and IgM antibodies against SL-IV was useful in leprosy and tuberculosis case finding program using a cutoff point of 0.150, and for serodiagnosis using a cutoff of 0.300.