Although the incidence of pulmonary tuberculosis has been reducing, the proportion of extra pulmonary tuberculosis is on the rise. This proportional rise in extra pulmonary tuberculosis has been associated with the HIV co-infection, because HIV patients are more susceptible for reactivation and dissemination of the tuberculosis infection. Tuberculosis of the head and neck region comprises about 10% of all the cases of extra-pulmonary tuberculosis and cervical lymph nodes are the most commonly affected 3 followed by laryngeal tuberculosis, deep neck space abscess and tuberculous otitis media. With improvement in economic and social conditions and the use of effective anti-tubercular therapy, there is decline in tuberculosis reported for several decades. It is now seen that extra-pulmonary presentations form a major proportion of new cases, especially since the advent of the acquired immunodeficiency syndrome epidemic. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region and its varied manifestations. We report the increased incidence of head and neck tuberculosis, its various presentations and clinical manifestations over a two year period.