Thyroid tuberculosis (TT) is an extremely rare condition, with acute abscess formation being the most uncommon form of presentation. Mycobacterium tuberculosis may affect the thyroid gland through hematogenous spread from an extra-thyroid focus of disease or by direct extension from adjacent cervical lymph nodes. Due to the non-specific imaging findings and the variable clinical manifestations, TT is rarely diagnosed promptly prior to percutaneous biopsy or surgery. The present study reports the dynamic monitoring of the sonographic features of a case with thyroid tuberculosis that was diagnosed by a thyroid ultrasound (US) scan, confirmed by a US-guided core-needle biopsy and followed-up sonographically during the whole course of treatment.