During the past 2 decades, tuberculosis has remerged as a major public health problem. Pulmonary tuberculosis is common; nasal tuberculosis is rare, tuberculosis of paranasal sinuses is much rarer. Non-specific symptoms are the stumbling block for clinical diagnosis. Here, we present a 42 yr old man, who presented with right eye ptosis for about 3 months. Endoscopic sinus surgery was performed to remove right sphenoid sinus lesion. The pathological report showed necrotizing granulomatous inflammation. Two weeks after surgery, his right eye symptom was recovered. The patient was commenced on antituberculosis medication and experienced steady improvement. No recurrence is noted till now after 6 months follow-up.