Abdominal tuberculosis involving the jejunum, although rare, can manifest with nonspecific symptoms, posing challenges in diagnosis and management, especially in elderly individuals. The clinical course of a 74-year-old man who complained of acute onset vomiting, constipation, and abdominal discomfort is described in this case report. He was eventually found to have a small intestinal (jejunal) blockage as a result of abdominal tuberculosis (TB). The patient's significant unintentional weight loss over six months further complicated the clinical presentation. Radiological investigations, including abdominal X-rays, ultrasonography, and CT scans played a crucial role in identifying features suggestive of small bowel obstruction and guiding further management. Additionally, histopathological examination of the resected small bowel confirmed the diagnosis of necrotizing granulomatous inflammation, likely of tuberculosis origin. Management involved a combination of antituberculous therapy and surgical intervention. This example emphasizes how crucial it is to rule out abdominal TB when making a differential diagnosis for older patients who exhibit vague gastrointestinal symptoms, particularly in areas where the disease is prevalent or in those who have recognized risk factors. Timely diagnosis and multidisciplinary management involving clinical, radiological, and surgical expertise are essential for achieving favorable outcomes in such cases.