Primary tuberculous epididymo-orchitis is a rare form of genito-urinary tuberculosis presenting as a painless or painful testicular swelling.Genito-urinary tuberculosis is an unusual presentation of tuberculosis. Primary genital involvement is seen in very few patients. We report a case of 24 year old male who presented with hard, painless swelling in the left testicular region mimicking as a testicular tumor for which he underwent ultrasonography and MRI followed by a left sided inguinal lymph node biopsy which revealed tuberculosis of tuberculous epididymo-orchitis. Early and accurate diagnosis of genito-urinary tuberculosis is needed to avoid complications.A complete course of anti-tuberculous treatment can cause complete resolution of the lesion.