Sinonasal tuberculosis is a rare disease; its association with osteomyelitis of surrounding bone and cervical lymphadenopathy has been reported rarely. In this article, we report a case of sinonasal tuberculosis that was complicated by osteomyelitis of the ethmoid bone and cervical lymphadenopathy. Infection of the bone was demonstrated by biopsy and 99mTc-MDP bone single photon emission computed tomography (SPECT), and cervical lymphadenopathy was confirmed by histology. This case will be discussed with specific emphasis on the imaging characteristics.