Miliary tuberculosis (TB) is a severe form of disseminated TB that could be fatal without treatment. It remains a significant health problem in endemic countries such as Indonesia. A-3-month-old child was admitted to the hospital with chief complain of shortness of breath, cough, and intermittent low-grade fever. Significant clinical findings were lack of weight gain, previous contact with confirmed cases of TB, and severe malnutrition. Significant laboratory findings were anemia, elevated CRP, and hypoalbuminemia. Radiological findings were suggestive of miliary TB with bilateral diffuse reticulonodular lung lesion on chest CT-scan. Diagnosis of miliary TB is difficult because of nonspecific, atypical symptoms and varied clinical signs. It is needed multiple diagnostic approach, especially for children. Miliary TB remain to be a difficult case that require an early intervention despite difficulties in its diagnosis, to prevent morbidity and mortality of patient.