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Although extremely rare, osteomyelitis has been reported in smaller bones like ribs. A 13-year-old male child presented with a one week history of chest wall swelling. Fine Needle Aspiration Cytology (FNAC) of the lesion and initial bacterial culture could not find the aetiology of the lesion. He underwent surgical resection of entire sixth rib for osteomyelitis and was subsequently diagnosed to have tubercular osteomyelitis. Diagnosis and treatment of rib tuberculosis is both difficult and controversial. Rib tuberculosis is often not successfully treated by medical management alone and consequently needs surgery.