Tuberculous dactylitis is rare musculoskeletal infection, but as emigration from developing countries increases it is likely to be seen more frequently. The author reports the case of a 23-year-old man with this condition. The radiologic features of tuberculous dactylitis include soft tissue swelling, periostitis with bone expansion and cortical destruction, diffuse uniform infiltration and localized osteitis. The major role of surgery is to provide tissue for diagnosis and to allow for the removal of caseous avascular tissue to promote distribution of drugs into surrounding tissues. An important aspect in the rehabilitation of these patients is early motion to prevent joint contracture and subsequent ankylosis.