Breast tuberculosis is a rare form of extra-pulmonary tuberculosis. It is rare in western countries, usually occurs in multiparous and lactating women but rare in male and older women. It has a varied clinical, radiological and pathological presentation that can be similar to that of a breast abscess or carcinoma. Constitutional symptoms are not usually present making it even harder to diagnose clinically. Here we present a case of a young Nepalese woman with tubercular mastitis who was initially misdiagnosed as breast abscess.