A nulliparous married female, aged 21 years, visited gynecologic OPD of the MS RMC with the complaints of pain abdomen and bleeding P/V since 1 month. PA examination revealed a soft to firm pelvic mass on left side. On vaginal examination, a large mass was palpated on left side which is firm in consistency. Severe anemia (Hb - 6.5 g/dL) and high ESR.USG of whole abdomen reveals a heterogeneous lesion in left adnexa mass measuring 102x57x54mm. Patient underwent USG guided aspiration of ovarian cyst. ZN Stain showed few acid fast bacilli. TB of the female genital tract is nearly always secondary to a focus elsewhere in the body. The clinical diagnosis of genital TB requires a high index of suspicion. The most common initial symptom of genital TB is infertility followed by menstrual disorders.

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