Aim: To describe various typical and atypical presentations of genital tuberculosis (TB) in females in endemic areas, explore the various methods of earlier detection, and the approach toward successful management of such cases. Background and objectives: In endemic areas, genital TB is a common cause of PID, yet is not easily picked up due to its indolent course. Increasing our insight into genital TB helps in earlier detection of such cases, providing us with more conservative management options, thus decreasing operative interventions and patient morbidity with brighter prognosis for patients and better fertility outcomes. Case description: We describe a series of seven gynecological cases with various presentations and outcomes for whom genital TB was found to be the culprit, ranging from those treated conservatively, to those requiring emergent management; as well as describing operative procedures and postsurgical complications such as surgical site infection (SSI). Clinical significance: Enlisting presentations of genital TB increases the index of suspicion in endemic areas for TB, helps in identifying better sampling methods and diagnostic methods for genital TB, helps in early eradication of the disease, and decreases patient morbidity. Conclusion:Tuberculosis is silent and can pose a nasty surprise to the unsuspecting clinician. So, a differential for a PID-like clinical scenario should always include TB and proper sampling methods to be identified for accurate detection and management.