Crohn's disease and tuberculosis are both granulomatous inflammation in histology and are hardly distinguishable if there is neither caseous necrosis nor acid-fast bacilli. We presented a 31-year-old woman with stable Crohn's disease complicated with culture-confirmed pulmonary tuberculosis. Histological examination of the laryngeal biopsy indicated granulomatous inflammation without caseous necrosis or acid-fast bacilli. After standard anti-tuberculosis treatment, her laryngeal lesion recovered.