Mycobacterial infections of the upper extremities are rare with musculoskeletal system involvement in 1–3% of tuberculosis patients and accounts for 10% of all extra–pulmonary tuberculosis. Elbow joint is most frequently involved in upper extremity accounting for 2 to 5% of all skeletal localizations. We report a case of extra spinal musculoskeletal Tuberculosis involving right elbow joint. Early diagnosis and treatment is important to prevent serious joint and bone destruction. Although biopsy is required to make definitive diagnosis, it is imperative that radiologists understand the typical distribution patterns and imaging manifestations. Reviews of literature with emphasis on imaging features are studied.