Tuberculosis (TB) is still endemic in developing countries like Pakistan. Tuberculosis affecting bones account for 1% of all TB infections. Calvarial tuberculosis, a rare manifestation of extra-pulmonary TB, accounts for 0.2%-1.3% of all cases of skeletal TB. Even in developing countries where TB is endemic, cases with this type of TB are not commonly seen. The most commonly involved sites are the frontal and parietal bones, with destruction of both the inner and outer table. Proper diagnosis and timely management help in improving prognosis. Here we describe the case of a 70-year-old male patient with pulmonary and extrapulmonary (calvarial) tuberculosis. The diagnosis was established on histopathological examination with demonstration of Acid-Fast Bacilli (AFB) and typical features seen on computed tomography (CT) scan.