Abdominal TB, one of the types of extrapulmonary TB, has unique ways of presentation, as seen in endemic regions like India. Only a few cases of it presenting primarily as inguinal hernia sac have been reported in literature. Early diagnosis from straw–colored fluid of the hernial sac and HPE of the sac is extremely rare. By reporting this case, the authors point towards high index of clinical suspicion which is to be kept in mind for such a presentation to facilitate early diagnosis and treatment of this dreaded disease, especially in endemic regions like India.