Abdominal tuberculosis is the third most common form of extrapulmonary tuberculosis. It can affect any part of the gastrointestinal tract from mouth to anus. The most common sites of involvement are the ileocecal region and ascending colon. Patients typically present with abdominal pain, weight loss, fever, and diarrhea or constipation. Diagnosis is based on clinical features, imaging, endoscopy, histology, and culture of tissue samples. Treatment involves a 6-month course of anti-tubercular medications with surgery for complications like obstruction or perforation. A high index of suspicion is needed for early diagnosis and management of this potentially lethal but curable disease.