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Tuberculosis of the central nervous system is an ominous consequence of disseminated tuberculosis which usually manifests as meningitis, an abscess or rarely as a tuberculoma. Though infrequent, intracranial tuberculomas especially within the sella, are notorious for simulating as pituitary tumors, by jeopardising pituitary hormonal function and exerting compressive effects on adjacent intracranial structures. However, a prompt evaluation can help tackle this diagnostic challenge with timely institution of anti-tuberculosis treatment, (ATT). Although in rare instances surgery may be a favourable option especially for managing extensive intrasellar masses, ATT usually facilitates resolution of such lesions. Long term hormonal replacement therapy may be required for established endocrine dysfunction.