A 68-year-old male presented with holocranial headache of four-month duration. Headache was mainly located in the frontal region with gradual diminution of vision on left eye for two months. On examination, patient was conscious, oriented, afebrile, vitals were normal with left temporal hemianopia with visual acuity 6/6. Cranial nerves were normal with no motor or sensory deficits. Biochemical, hematological profile was normal. X-ray chest showed prominent bronchovascular markings. Endocrinal study revealed prolactin 8.6 ng / ml (normal range 1-25) and GH 1.8 ng / ml (normal range 0-3), T4 7.6mg/dl (range 5-12), T3 2.5 nmol/ L (1.2-3.1), TSH - 3.8 mI U/ml (2-5). Contrast T1W MRI study revealed ring enhancing mass in sella with hypo intensity at center with suprasellar extension, T2W MRI showed homogenously hyper intense lesion. A right sub frontal osteoplastic flap craniotomy was done. The suprasellar lesion had thick wall, with caseous material inside; sella evacuated by ring curette. The lesion was avascular and postoperative period was uneventful. Patient was put on antibiotics and continuous lumbar drainage. Histopathological examination revealed diffuse infiltration of lymphocyte with destruction of pituitary gland and multiple foci of epitheliod and langhanse giant cells. Zheil Nelson staining and culture of caseous material was negative for acid fast bacilli. No fungus was isolated. Polymerase chain reaction (PCR) for Myobacterium tuberculosis was positive. Patient was put on standard anti-tuberculosis treatment for 18 months. On follow-up, there was no headache; visual symptoms also improved.