Tuberculosis affects a large number of people worldwide and the incidence is increasing. Tuberculosis bacilli reach the genital tract mainly by haematogenous spread from foci outside the genitalia. The fallopian tubes, endometrium and ovaries are affected in most cases. Genital tuberculosis may be asymptomatic and could go unrecognised or masquerade as other gynaecological conditions. A combination of tuberculin testing, culture, histology, hysterosalpingogram and nucleic acid amplification testing is useful in establishing a diagnosis. Multidrug anti-tuberculosis chemotherapy is the mainstay of treatment. After treatment spontaneous conception is low with an increased risk of ectopic pregnancy and spontaneous miscarriage.