Extrapulmonary tuberculosis remains a significant clinical problem because symptoms and signs may be difficult to recognize and to relate to tuberculosis. Furthermore, the poor accessibility of the tissues involved often makes the diagnosis difficult. In extrapulmonary tuberculosis the lungs may also be affected, but the involvement of extrapulmonary organs is predominant. Extrapulmonary tuberculosis may affect more than one organ, and even cause a severe systemic disease. The most frequent sites of extrapulmonary tuberculosis are the pleura and lymph nodes. The most important mechanisms of dissemination of Mycobacterium tuberculosis to the different extrapulmonary organs are lymphohaematogenous dissemination and contiguous spread. In most cases, extrapulmonary tuberculosis should be treated according to the principles and with the drug regimens recommended for pulmonary tuberculosis.