Introduction:Abdominal Tuberculosisin all its grandeur still rules the roost in third world countries like ours. The mainobjectiveofthis studyistoidentify the changes that may have occurred over time in the presentation and treatment of this disease.Material and Methods:This  prospective study on 50 patientswas carried out at Indira Gandhi Institute Of Medical Sciences, Patna admittedfromOctober 2016toSeptember 2017 in the surgery wards. Only thosepatients in whom abdominal tuberculosis was confirmed by imaging or histopathology were included in this study. A meticulous record of thedemography,presentation, investigation and treatment was maintained in a previously prepared proforma for this purpose. All relevant data was analyzed using SPSS software version 17.Results:30(60%) patients were male and 20 (40%) were female with age ranging from 11–60 years. All patients belonged to a low socioeconomic group. 18(36%) patients presented in the emergency as complete intestinal obstruction, 8(16%) had incomplete bowel obstruction and 5(10%) presented with bowel perforation, all diagnosed on plain x–ray abdomen (AP view). The rest 19(38%) patients were diagnosed on abdominal ultrasonographic findings of ascites, ileocaecal mass/ abscess, thickened terminal ileum. Only 10(20%) required CECT for further clarification. 15(30%) of all patients were treated conservatively. Adhesiolysis in 10(20%) was the commonest surgical procedure performed. Conclusion:Abdominaltuberculosis in our region should always be considered in patients presenting with small bowel obstruction or chronic ascites of unknown etiology. Anti tubercular treatment 2(HRZE) /4(HR)for a minimum of 6 months is all that is required in most patients.