Abstract: Gastrointestinal tuberculosis, an endemic disease in India and Africa continues to surprise us with its myriad ways of presentation. In a resource poor country like ours high index of suspicion based on meticulous clinical and vigilant intraoperative examination of the pathological tissues can often unravel coexisting diagnosis. We describe here an interesting case of hernia sac tuberculosis suspected on an unreported physical finding of presence of palpable nodule at the hernial site. Clinical suspicion prompted cautious intraoperative search for any abnormality of the hernia sac and its contents. Firm, nodular swellings were found on the hernial sac wall which were confirmed on histopathological examination as tuberculous granulomas.