Isolated involvement of the spleen is a rare manifestation of childhood tuberculosis. The rare occurrence and presence of nonspecific clinical features often pose diagnostic challenges even in countries where tuberculosis is endemic. Splenectomy is often performed for establishing the diagnosis or achieving a cure in combination with antitubercular therapy (ATT). In this report, we describe a boy who presented with nonspecific symptoms and was detected to have a well-defined lesion in the spleen on ultrasonography. The diagnosis of tubercular splenic abscess was made after line probe assay for the detection of Mycobacterium tuberculosis and cytomorphology of the aspirated material. The tubercular abscess showed complete healing after 9 months of four-drug ATT.