Tuberculosis (TB) is the leading cause of morbidity and mortality in developing countries. The involvement of liver the in the form of tubercular liver abscess is a very rare entity in immunocompetent or non-HIV infected individuals. Here we report a case of 32-year old previously healthy male who presented with easy fatigability, decreased appetite, abdominal pain and low-grade fever. Further examination and relevant investigations revealed diagnosis of tubercular liver abscess with pleural effusion and inferior vena cava (IVC) thrombosis. The patient was treated with anti-tubercular drugs and anti-coagulants; he improved symptomatically and recovered without any further complications. Although tubercular liver abscesswith IVC thrombosis is a relatively unusual manifestation, timely diagnosis is essential to prevent devastating complications.