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Introduction: Tuberculosis (TB) of the ankle is an uncommon presentation of extrapulmonary infection. The early diagnosis of TB arthritis of the ankle is difficult because of the uncommon site, the ability of TB to mimic other disorders and, all too common, lack of awareness of about this infection in ankle joint., Case Report: A 30-year-old male presented with a 1-year history of right ankle pain and swelling. He denied any history of recent infection but had had recurrent ankle pain that had been treated accordingly. When he visited our outpatient clinic, he was afebrile. The patient, despite a period of conservative treatment, presented with a localized painful fullness of the ankle. Magnetic resonance imaging helps for the diagnosis with variable specificity, but TB arthritis was diagnosed through a diagnostic arthroscopic procedure, and anti-TB therapy eventually eradicated the infection., Conclusion: It is highly recommended that early biopsy and synovial fluid for polymerase chain reaction GeneXpert be performed in suspicious cases to confirm and treat accordingly., Competing Interests: Conflict of Interest: Nil