Tuberculosis (TB) arthritis accounts for approximately 1-3% of all cases of tuberculosis and for approximately 10-11% of extrapulmonary cases. TB arthritis primarily involves the large weight-bearing joints, in particular the hips, knees, and ankles, and occasionally involves smaller nonweight-bearing joints. The diagnosis of TB arthritis is often delayed due to lack of awareness, insidious onset, lack of characteristic early radiographic findings and often lack of constitutional or pulmonary involvement. Intense current and previous efforts into diagnostic, therapeutic, and preventive interventions have focused on pulmonary TB in adults, but TB arthritis has been relatively neglected. Additional research, understanding, and prevention of TB arthritis are urgently needed. In this article, we review the epidemiology, diagnosis, and principles of treatment of TB arthritis.