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Tuberculous pericarditis is caused by Mycobacterium Tuberculosis, it is found in approximately 1% of all cases of tuberculosis and 1 to 2 % of cases of pulmonary tuberculosis.1 It can be  fatal even with proper diagnosis and treatment.2 Although there has been a significant decline in wealthy industralized countries over years, Africa, Asia and Latin America with 86% of world’s population, comprise 95% of all cases of tuberculosis and 98% of nearly 2 millon fatalities from the tuberculosis each year.3 We are reporting this case because the patient was diagnosed and managed in the resource limited settings, guided mostly by clinical judgement and there has been a good response to therapy.