The resurgence of tuberculosis world-wide and its association with HIV infection means a greater likelihood of otolaryngologists encountering the disease in one form or another. In this review the features of primary and secondary tuberculosis in various head and neck sites are described, and recent advances in diagnosis are discussed. For the otolaryngologists other important aspects such as infections with atypical mycobacteria, the differential diagnosis of cervical lymphadenopathy in HIV-infected patients, recently recognized problems in drug treatment, and the role of surgery in head and neck tuberculosis are also discussed.