Tuberculosis remains a major cause of morbidity and mortality in Colombia and the world, with an increase in extra-pulmonary forms, amongst which intestinal involvement ranks sixth. Clinical manifestations are nonspecific and can mimic many conditions that make diagnosis a clinical challenge. This article describes the case of a patient with intestinal tuberculosis, for whom a confirmatory finding was not documented, but due to clinical suspicion and paraclinical suggestive findings, it was decided to initiate TB treatment. The patient presented a favorable clinical response after two weeks of onset.