Tuberculosis (TB) continues to be a major health problem for the developing world and a rise in the number of cases has been noted in the western hemisphere too. TB can affect most organs in the head and neck region, such as the lymph nodes, larynx, middle ear, oral cavity and pharynx. In particular, as for cervical tuberculosis lymphadenopathy, a predominant involvement of the posterior triangle, supraclavicular, and internal jugular group of nodes bilaterally can be observed. As the early manifestation of Head and Neck TB is often similar to neoplasms, clinical consideration usually occurs only after an ineffective anti-inflammatory treatment, fine-needle aspiration, or biopsy/resection. In fact, this type of presentation often represents a diagnostic and therapeutic challenge to the clinician. Therefore, the aim of the present article is to present and discuss the management of a case of cervical tuberculosis lymphadenopathy.