Tuberculosis (TB) isa major global public healthconcern. The extrapulmonary manifestations ofTB can bemisleading and challenging todiagnose.Thoracic cold abscessis a rare and unusualentity of TB.Itrepresents 1-5% of musculoskeletal localisations of TB and constitutes a differentialdiagnosiswithpyogenicabscess, slow-growingpathogens or walltumours. In endemic areas, anypainless progressive abscessshouldsuggest a tuberculosis infection. Despite the clear diagnostic contribution of molecularbiologywith the Xpert MTB/Rif, a positive culture on a sample of fluid or tissue remains the gold standard. The management of tuberculousthoracicabscessiscontroversial and the combination of standard chemotherapy and surgeryseems to be the mostappropriate. Hereinwe report a case of a cold thoracicabscess in a 35-year-old man with no previoushistory.