Inguinal masses are common presentations in clinical practice, often attributed to hernias. However, atypical features may lead to diagnostic difficulties and delayed intervention. We present a case of a 32-year-old Ethiopian woman with a prolonged history of a growing groin mass 2 months following childbirth, her diagnosis potentially challenged by her recent obstetric history. Despite previous evaluations suggesting inguinal hernia, her symptoms worsened, prompting an emergency department visit. Further investigation revealed an unexpected diagnosis of intraabdominal tuberculosis, manifesting as a large iliopsoas abscess. This case underscores the importance of considering uncommon etiologies in the differential diagnosis of inguinal masses, particularly in high-risk populations with comparable situations, to ensure timely diagnosis and intervention.