This report describes a case of renal tuberculosis, complicated by hypertension and ureteric obstruction, in a previously well Australian born child. Despite antituberculous chemotherapy and ureteric stenting, there was a progressive loss of renal function in the right kidney until surgical nephrectomy allowed full recovery. A high level of clinical suspicion is necessary for a diagnosis of genitourinary tuberculosis. Ureteric cicatrisation and obstruction occasionally may occur with healing, and therefore serial renal tract imaging during treatment is necessary to detect this complication.