Tuberculosis is one of the leading causes of mortality. Tuberculosis and TB with HIV related mortality was as high as 38.8 per 100,000 population in India with incidence of tuberculosis being 217 per 100,000. Central nervous system (CNS) tuberculosis comprises 1% of the total patients with tuberculous infection. One of the most common causes of chronic meningitis in India is tuberculous meningitis (TBM). This chapter covers the clinical features of TBM, investigations, complications, and treatment. TBM patients may have prodromal symptoms of anorexia, malaise and weight loss. Validation of the diagnosis of TBM is often hard and delay in commencement of treatment is concomitant with increased mortality and morbidity. Hence, treatment of TBM is often started empirically in a high prevalence country like India. British Infection Society recommends daily medication for all forms of tuberculosis.