BACKGROUND–Abdominal tuberculosis is an increasingly common disease with variable presentations. In GIT, the most common site for tuberculosis is ileocecal region with gastro–duodenal involvement seen in only 1 to 2% of all cases. Narrowing of the third part of duodenum, which is the most common site of duodenal tuberculosis, may give the impression of Superior Mesenteric Artery Syndrome. We report here two unusual cases of duodenal tuberculosis that presented as Superior Mesenteric Artery Syndrome. CASE SUMMARY– Two females of 22 and 25 years of age presenting with the chief complaints of pain all over abdomen and multiple episodes of vomiting for about 4 months along with a history of bloating, early satiety and weight loss. Multiple enlarged hypodense necrotic periportal, portocaval and mesenteric lymph nodes were noted in one case while a duodenal stricture was noted in the other. Both the patients were successfully managed by laparoscopic duodenojejunostomy followed by anti–tubercular treatment for a period of one year with a complete recovery and no post–operative complications.