Tubercular appendicitis is surprisingly rare, even in countries where this infection is endemic. We report a case of isolated tubercular appendicitis with atypical presentation. A39 yearmale patient presented with abdominal pain and mild fever. On the basis of Ultrasonography and CECT findings, the patient was diagnosed as a case of appendicitis with perforation. Percutaneous (PC) drainage of the fluid revealed acid fast bacilli however no detectable tubercular focus was found elsewhere in the body. The patient was managed conservatively. Preoperative diagnosis of primary tubercular appendicitis is rarely made. It needs high index of suspicion. It should always be confirmed by histopathology.