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Extra-pulmonary Tuberculosis (EPTB), 10% about is musculoskeletal cases. A middle age female who presented to outpatient department of tertiary care center (Medical college & Hospital) with swelling over volar surface of right distal forearm gradually increased in size over 9 to 10 months. She noticed difficulty to move fingers of right hand as size of swelling increasing. She had tingling sensation in the territory of median nerve. It was single swelling of 05cm x 07cm over the volar surface of right distal forearm with defined margins. Lesion was open surgically and rice bodies were found. Histopathological examination had shown caseous type of necrosis and granuloma formation suggestive of tuberculosis. Anti-tuberculosis treatment was given to her. Cases of TB tenosynovitis are uncommon and diagnosis is often missed causing delay of treatment to patient. Surgical intervention decided by symptoms and signs. Antitubercular therapy and excision of lesion produce good outcome.