Female genital tuberculosis (FGTB) is a common health problem in developing countries. It frequently causes pelvic inflammatory disease, menstrual abnormalities and infertility. It represents 15-20% of extrapulmonary tuberculosis. It is mostly secondary infection acquired from hematogenous spread from extra-genital source such as pulmonary or abdominal tuberculosis. The fallopian tube is affected in almost all the cases followed by endometrium and cervix. It occurs in the most economically productive age of 15-45 years causing infertility in 44-74% of individuals affected. The clinical diagnosis of genital TB requires a high index of suspicion. Infertility and menstrual irregularities are the commonest presentation. Diagnosis requires a multi-modality approach involving clinical, radiological, bacteriological, molecular and histopathological methods. Treatment requires the combination of four drugs (Rifampicin, Isoniazid, ethambutol and pyrazinamide) for a minimum of six months duration. In case of drug resistant tuberculosis reserve drugs are used for the extended period.