Tuberculosis of the hand and wrist account for less than 1 percent of musculoskeletal tuberculosis cases, and carpal tunnel syndrome secondary to tuberculosis is very rare. Because the symptoms of tuberculosis of the hand and wrist mimic those of rheumatoid synovitis or non-specific chronic synovitis, the final diagnosis and the appropriate treatment may be delayed. We describe the case of a patient who presented with carpal tunnel syndrome secondary to tuberculous tenosynovitis.