Tuberculosis of central nervous system is not uncommon in children of developing countries. Tuberculomaswere initially misdiagnosed due to lack of radiological expertise, un availability of CT scans and MRI. For early diagnosis and treatment, they should be kept in differential of space occupying lesions.We had a 2 ½ years old patient had fever, squint, aphasia and loss of motor milestones. On examination he was a malnourished child with right sided hypertonia and involvement of 9th and 10th cranial nerves with hepato spleenomegaly. His CRP was raised and CXRshowed B/L milliary shadowing which helped us to find out the primary focus leading to tuberculoma. His PCR test of blood was positive for Mycobacterium tuberculosis while CSF examination was normal. His work up led us to the diagnosis of a space occupying lesion i.etuberculoma, fungal infection of brain or metastasis. He was managed conservatively as he responded well to antituberculous therapy along with steroids. This concludes that early and prompt treatment of this deadliest disease is the key for favorable outcome.