The frequency of tuberculous cerebral involvement associated with miliary tuberculosis is not well known; some authors have evaluated it at around 22%. We report the case of a 43-year-old man hospitalised in the pulmonology department with bacillary positive miliary tuberculosis. On the 26th day of antituberculosis treatment he complained of frontal headaches, with impairment in visual acuity. Examination of the optic fundus showed bilateral papillary oedema. Cerebral computed tomography showed diffuse rounded lesions with significant oedema. Antituberculosis chemotherapy was supplemented with steroid treatment. Clinical and radiological progress was good.