Tuberculosis of the pancreas is very rare and can present with many signs and symptoms, including obstructive jaundice, weight loss and a mass in the head of the pancreas. Hence the diagnosis of pancreatic tuberculosis remains a challenge and a high index of suspicion is required. If a tumour is suspected then an ultrasound- or CT-guided fine needle aspiration should be performed. Even if the initial microbiological results are negative, using conventional techniques, PCR can yield more rapid results and avoid an unnecessary laparotomy.