Tuberculosis (TB) is one of leading causes of death, especially in developing countries. Common manifestations of TB include pulmonary symptoms with fever like, cough and pleuritic chest pain. Tubercular meningitis or tubercular brain abscess (TBA) is one of the rare manifestations of tuberculosis which leads to marked morbidity and mortality in TB patients. Prevalence of TBA is approximately 4-8% in immunocompetent individual however, in individual with pre-existing immunocompromised state like, HIV seropositive individual occurrence of TBA is shoots up to 20%. Here, we reported a case of 45-year-old male patient on anti-retroviral therapy (ART) with known status of HIV positive, presented with headache, fever and vomiting since several days. On admission, lab investigations revealed, mild leukocytosis with raised ESR and CRP. Non-contrast computed tomography (NCCT) of brain shows single ring enhancing lesion mimicking brain abscess. Further investigations confirmed tuberculosis infection. CSF analysis also suggestive of tubercular meningitis. Stereotactic aspiration of abscess was done with in situ catheter for drain residual fluid. Along with surgical management, anti-tubercular therapy (ATT) was also initiated in patient to control tubercular infection and prevent recurrence. Due to extensive treatment with ATT, ZN stain become negative and CXR return partially to normal state without any residual clinical symptoms and focal neurological deficit.