Genitourinary tuberculosis accounts for 8-15 % of cases of extrapulmonary tuberculosis, with the testis being an infrequent site of involvement, seen in 3 % of individuals with genital tuberculosis. Testicular tuberculosis often presents with symptoms that mimic those of other testicular conditions, including neoplasms, infections and testicular torsion. We report the case of a 51-year-old male with a history of tuberculosis 11 years prior, who presented with left testicular pain, swelling, and an ulcer. Initial ultrasound findings suggested were unclear and only the histopathological examination ultimately confirmed a diagnosis of testicular tuberculosis. The patient was treated with complete clinical resolution.