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Tuberculous tenosynovitis of flexor tendons of wrist and hand is a rare disease. The incidence of extra-pulmonary tuberculosis including musculoskeletal system has also increased with re-emergence of tuberculosis due to increase in HIV/AIDS cases. We are reporting a case of 45 years old HIV and diabetic male who presented with a swelling and pain in left wrist. Patient was managed by open biopsy with excision of thickened synovium and sample send for histopathological examination. Histopathological report revealed inflammatory lesions with granulomatous epitheloid and giant cells, staining for AFB was negative. ATT was advised to patient for 9 months with regular follow-up. Patient gained full range of motion in wrist last follow-up. The tuberculous tenosynovitis is rare but must be kept in mind as differential diagnosis of chronic tenosynovitis.