Abdominal tuberculosis presenting as anemia refractory to standard therapy in an elderly male

India bears a significant proportion of tuberculosis cases, accounting for approximately 28% of the global burden. Among the reported global cases, around 16% constitute extrapulmonary tuberculosis (EPTB). EPTB diagnosis and treatment are usually challenging. The diagnosis frequently requires the application of contemporary methods, such as acquiring extrapulmonary samples and utilizing advanced diagnostic tools that involve immunological and molecular techniques. Here, we present a case of an elderly male who presented with constitutional symptoms and severe anemia which was refractory to standard hematinic and transfusion therapy. The patient was diagnosed to be a case of abdominal tuberculosis and improved with antitubercular therapy.