To evaluate the integration of tuberculosis (TB) screening and contact investigation into Integrated Maternal, Neonatal and Child Illnesses (IMNCI) and TB clinics in Addis Ababa, Ethiopia, this study used mixed methods with a stepped-wedge design, where 30 randomly selected health care facilities were randomized into three groups of 10 during August 2016-November 2017. Overall, 180,896 children attended 30 IMNCI clinics and 145,444 (80.4%) were screened for TB. A total of 688 (0.4%) children had presumptive TB and 47 (0.03%) had TB. Integrating TB screening into IMNCI clinics and intensifying contact investigation in TB clinics is feasible for improving TB screening, presumed TB cases, TB cases, contact screening and IPT coverage during the intervention period. Stool specimen could be non-invasive to address the challenge of sputum collection.