Tuberculosis is a bacterial infection that more commonly affects the lungs of immunosuppressed patients and still represents a serious public health problem in many parts of the world, especially in developing countries. The infection is caused by inhalation of the mycobacteria, which can cause low-grade fever, persistent cough, fatigue, night sweats, and weight loss in symptomatic individuals. Extrapulmonary manifestations of the disease may occur, more often as a consequence of hematogenic or lymphatic dissemination of the bacilli. The oral manifestation of tuberculosis is unusual and more commonly occurs in the tongue, followed by the palate and the buccal mucosa, manifesting as painful ulcerations with indurated and ill-defined borders that may simulate oral squamous cell carcinoma. The maxillary bones and major salivary glands can also be affected. Microscopically, a granulomatous inflammatory process is observed, usually with caseating necrosis. The demonstration of the bacteria is necessary to confirm the diagnosis, which, on biopsy specimens, can be done by special histologic stains or molecular approaches. Treatment comprises the use of antibiotics for several months, and such a long duration of therapy represents one of the obstacles to correctly treating the patients. Mortality rates remain high in some low-income countries.