Tuberculous bacilli have lived in symbiosis with mankind since the ascent of Homo sapiens on earth. Globally, nearly 30 million people suffer from tuberculosis. Due to marked improvement in the socioeconomic status and the availability of effective antitubercular drugs, there was a great hope for elimination of the disease. However, the optimism was short lived because of the impact of the AIDS pandemic. Tuberculosis has again become an epidemic in many parts of the world. Despite advances in imaging techniques, better understanding of microbiological, histological and immunological biologies, availability of effective antimycobacterial chemotherapies and sophisticated and safe operative procedures, there are many grey or unresolved areas that need to be addressed.