Thyroid tuberculosis although known to be a rare entity provides a diagnostic challenge to the clinician. Clinically,  radiologically and even histologically proving to be difficult to arrive at a diagnosis. This article aims to summarize the efforts of multiple individuals having encountered such cases in their clinical practise and come to a consensus regarding the diagnostic and treatment hurdles one may face.

                In any case of thyroid swelling, FNAC seems to be the most important diagnostic modality though it doesn’t always prove to be accurate. If so confirmed standard ATT will suffice reducing the need for unnecessary surgery. In cases where surgery is indicated(be it abscess drainage or thyroidectomy) histopathology provides the undisputable diagnosis. Newer modalities like gene Xpert must also be tried in future when the diagnosis is in doubt.