Testicular tuberculosis (TB) is a rare form of genitourinary TB. It presents as a painless or slightly painful scrotal swelling and so it is difficult to differentiate from typical epididymo-orchitis or other conditions such as tumor or infraction. Middle aged males, especially of 20–40 years of age are most commonly affected, and presented with painful or painless scrotal swelling with or without discharging sinus. Epididymal involvement is usually seen in testicular TB. Ultrasound (USG) and USG-guided fine needle aspiration cytology of testicular swelling for the diagnosis was done, CBNAAT of aspirated fluid of testicular swelling confirm the diagnosis. Anti-TB chemotherapy is the mainstay of treatment to ensure the complete resolution of the lesion. However, in very few cases, surgical removal is required for both diagnosis and treatment. Here, we report a very rare case of left sided isolated testicular TB in a 60-year-old male who was completely cured with 6 months regimen of anti-TB chemotherapy.