A 78-year-old male presented with cough, breathlessness, chest pain and haemoptysis. He had a history of pulmonary tuberculosis treated 2 years prior. Investigations revealed a cavitary lesion in his left lung containing a fungal mass. He was diagnosed with pulmonary aspergilloma developing in a pre-existing cavity from prior tuberculosis. Pulmonary aspergilloma occurs due to the fungus Aspergillus fumigatus infecting cavities left by healed tuberculosis. It was treated successfully with intravenous amphotericin B and oral itraconazole for 6 months. Relevant examinations and tests are needed to differentiate pulmonary aspergilloma from other conditions like lung cancer and properly