Nasopharyngeal tuberculosis is a rare disease. Even in areas where tuberculosis is endemic, its incidence is also extremely low. Here, we will report a rare case of nasopharyngeal tuberculosis. A 29-year-old male patient presented with a 2-month history of sore throat, nasal congestion, dysphagia, and low-grade fever. Thickened mucosa in the posterior wall of the nasopharynx was shown from nasopharyngoscopy, covered with a thick, yellowish, purulent secretion that was not easily removed. Computed tomography of the nasopharynx showed thickening of the mucosa in the right and left bilateral walls and the posterior wall with indistinct margins. Histopathological examination diagnosed nasopharyngeal tuberculosis granuloma. Nasopharyngeal tuberculosis is rare and has atypical symptoms. When a new organism appears in the nasopharynx, it should be differentiated from tuberculosis, autoimmune diseases, and tumors, and a tissue biopsy of the new organism should be performed to make a final diagnosis based on histopathology.