Introduction:Gastrointestinal tuberculosis (TB) is a rare extrapulmonary manifestation of TB.1 Involvement of terminal ileum, cecum, and peritoneum are more commonly documented while esophageal involvement accounts for less than 0.2% of all TB patients.2-4 Despite the lower incidence of TB in Western countries, given the vague clinical manifestations of gastrointestinal TB, clinicians are required to keep TB on their differentials in work-up of various gastrointestinal symptoms, even if the patient has been previously vaccinated. We present a unique case of esophageal and duodenal TB in a patient who was vaccinated with BCG, with a prior negative Mantoux tuberculin skin test (TST).