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Objective: To report a case of naso-sinus tuberculosis and discuss its diagnosis and management in our context. Clinical Case: A 37-year-old patient, with no previous history, visited us for a swelling under left orbital including a nasal obstruction and intermittent frontal headaches, which has been developed since about one year. Clinical Examination: The anamnesis founds no notion of epistaxis, visual disability, nor notion of fever. It has been noted a swelling under left angulo orbital during physical examination, a burgeoning mass filling the left nasal including a Lymphadenopathy under homolateral mandibular. Para clinical investigations in particular CT scan of the sinuses have highlighted a tissue process under orbital with a left naso-ethmoido-maxillary extension. The anatomical pathologic examination of the biopsy carried out through endoscopy permitted to highlight epithelioid giganto-cell granulomas with caseous necrosis evoking tuberculosis. The patient has been prescribed an anti-tuberculosis treatment. The course of illness is marked by the healing of the patient.