A 29-year-old nonsmoker lady presented to our department with complaints of fever and productive cough of three-week duration. Her chest radiograph showed bilateral infiltrates more so in upper zones (Figure 1). She had normal haematological and biochemical parameters. There was no clinical evidence of any immunosupression. Acid fast bacilli were found in sputum smears and subsequently culture demonstrated Mycobacterium tuberculosis. She was advised of category 1 regimen of the Revised National Tuberculosis Control Programme of India which consists of isoniazid, rifampicin, ethambutol, and pyrazinamide three times weekly for 2 months followed by isoniazid and rifampicin three times weekly for 4 months, but she refused the same and was prescribed daily regimen consisting of isoniazid (300 mg), rifampicin (450 mg), ethambutol (600 mg), and pyrazinamide (1250 mg) for two months followed by isoniazid (300 mg) and rifampicin (450 mg) for four months. After three months of chemotherapy she was readmitted in our emergency department with complaints of left-sided pleuritic chest pain and exertional breathlessness. Her chest radiograph showed pneumothorax on left side (Figure 2(a)) and corresponding computed tomography of thorax (CT) showed massive pneumothorax of left side with infiltrates and cystic spaces in right upper lobe (Figure 2(b)). The patient was advised of intercostal tube drainage but she refused. So she was managed conservatively with oxygen, cough suppressants, and bed rest. Since the patient was smear and culture positive for Mycobacterium tuberculosis, both were repeated and the results were negative. With supportive care, her condition improved and was discharged with the advice to continue antituberculosis drugs and to be on regular follow-up. Chest X-ray and CT at the completion of six months of chemotherapy regimen showed complete resolution of pneumothorax (Figures 3(a) and 3(b)). The patient is under our regular follow-up without any complications.