Tuberculosis typically in majority of cases affects the lungs. Extrapulmonary tuberculosis affecting the bone is usually limited to the long bones and vertebral bodies. Rarely, does a case of tuberculosis affect the oro-fascial structures. We present a case of a 14 year old male child who presented with progressive swelling of the right maxilla with constitutional symptoms of evening rise of temperature and weight loss. On imaging it appeared to be more suggestive of malignant involvement but was confirmed to be tuberculous osteomyelitis of the maxilla after excision biopsy. Multiple foci in the brain, abdomen and various groups of lymph nodes were also found. The patient was started on treatment and followed up.