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Background: It is a very common experience of many physicians that a good number of extrapulmonary tuberculosis patients are suffering from asymptomatic pulmonary koch’s and many times it is diagnosed as a chance finding by chest X ray during routine investigation for general health check up or assessment for fitness purpose. Methodology: The present study was the cross-sectional study conducted on the randomly selected cases of extrapulmonary tuberculosis. A pre-designed semi-structured questionnaire was used to find out the presence of respiratory signs suggestive of symptomatic or asymptomatic pulmonary tuberculosis. In all participants, chest X ray, sputum for Acid Fast Bacilli (AFB), Complete Blood Count (CBC), ESR was done to find out or support pulmonary tuberculosis pathology. Results: Out of 140 patients of extrapulmonary tuberculosis 39.3% had pleural effusion, while almost similar number had abdominal Koch’s (37.9%) in the form of ileo-caecal Koch’s, mesenteric and para-aortic lymph nodes enlargement and tuberculous ascites. Pulmonary Koch’s was found out in 20 patients i.e. 14.3% of patients. Conclusion: Profile of pulmonary pathology in extrapulmonary tuberculosis is not very high. We found only a small proportion (14.3%) of patients having associated pulmonary Koch’s that too was asymptomatic in majority (65%).Tuberculous pleural effusion and intestinal koch’s are the two commonest forms of extrapulmonary involvement.