A 45 year old female developed painless, enlarging induration at the site of an incisional scar. Although an incision biopsy was unrevealing, CT scan showed a large parietal mass infiltrating the omentum and right ureter with evidence of obstructive uropathy. With a diagnosis of abdominal desmoid tumor, surgery was undertaken. The involved structures, including the right rectus abdominis muscle, uterus and right adnexa, which were also involved, were removed. Histopathology report of the resected specimen revealed epithelioid granulomas with caseous necrosis with the final diagnosis of tuberculosis. The patient was subsequently started on anti- tubercular drugs and is doing well. Involvement of the anterior abdominal wall by tuberculosis, especially in immunocompetent individuals, is rare. This experience goes to demonstrate the seemingly endless forms and presentations of this ancient disease. Failure to have tuberculosis in the list of differential diagnosis is to set oneself up for disaster.