Esophageal tuberculosis is a rare clinical picture. It is typically secondary to tuberculous infection of other organs. There are neither diagnostic signs or symptoms nor typical x-ray or laboratory findings. Histology, too, often fails to establish a reliable diagnosis, so that esophageal tuberculosis might be mistaken for esophageal carcinoma. We report the case of a woman with secondary esophageal tuberculosis to illustrate the clinical course and diagnostic problems of this condition.