Thyroid tuberculosis is a very rare entity and its diagnosis is based on the histopathological findings. In this report, we presented a 57 year-old women with palpable neck mass that finally diagnosed as thyroid tuberculosis. Ultrasonography showed bilaterally enlarged thyroid lobes with multiple hypoechogenic heterogenous solid nodules. Except elevated erythrocyte sedimentation rate, all of other laboratory test results including those of thyroid functions were within normal limits. Computed tomography of thorax revealed no abnormality. Intraoperatively purulent hard and irregular masses were seen. Due to suspicion of malignancy, bilateral total thyroidectomy was performed. Histopthological examination confirmed the diagnosis of tuberculosis. The patient received 6 months of antituberculous therapy and put on continuous thyroid hormone replacement.