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Mediastinal tuberculosis is a rare infection resulting from direct inoculation of organisms or through hematogenous spread. Infected lymph nodes may also transfer the bacilli through lymphatic route. Mediastinal tuberculosis may resemble a pyogenic abscess or tumour which might indicate tubercular aetiology and remains a clinical challenge. In tuberculosis endemic countries like India, all the abscesses indolent to routine treatment need investigation to rule out mycobacterial causes. Authors hereby report a case of 60-year-old male with anterior mediastinal tubercular abscess.