A 28-year-old man presented with a swelling just below the left eyebrow area of 1-month duration. On examination, a firm, non-tender mass could be palpated in the inferior portion of the superior orbital rim (Figure 5A). The rest of ocular evaluation was normal. CT scan orbits showed a soft tissue swelling inseparable from the left orbital rim (Figure 5B). Excision biopsy of this lesion revealed granulomatous inflammation with caseation (Figure 5C). GMS and ZN staining were negative, while PCR for MTb was positive. Other laboratory investigations showed an increase in ESR (42 mm/h), normal CT thorax, positive Mantoux and QuantiFERON TB gold tests. He was started on four-drug regimen of ATT (isoniazid, rifampicin, ethambutol and pyrazinamide). At the last follow-up of 8 months, he is doing well with no recurrence of mass or lesion.