Amongst various forms of TB, TB of the gastrointestinal tract is the sixth most frequent form of extra-pulmonary TB. Though any part of the gastrointestinal tract can be involved, the most common site of involvement is ileocaecal region. It can have a varied presentation, frequently mimicking other diseases, thus causing delay in diagnosis and management. Therefore a high degree of suspicion along with proper use of diagnostic modalities is essential for timely diagnosis of the disease. Here, we present a case of isolation of a strain of MTB complex resistant to rifampicin from stool specimen of a retroviral disease patient diagnosed with abdominal Koch__ampersandsignrsquo;s.