Predicting risk areas of tuberculosis (TB) epidemics needs a proper understanding of the disease transmission process in identifying holistic risk factors. This study was performed to determine the causative factors triggering the epidemics in Shah Alam, Malaysia by utilising spatial analysis techniques and participation of local-expert knowledge or local spatial knowledge (LSK) approach. LSK approach was conducted to collect data on TB risk factors by combining experienced local experts' opinions, multi-criteria decision making (MCDM) analysis, and GIS mapping. The combination of experts participatory GIS and knowledge elicitation can generate a useful spatial knowledge framework for risk assessment of local epidemics.