As per the World Health Organization (WHO), children below 15 years constitute 11% of all tuberculosis patients worldwide. About 1.1 million children fall ill due to tuberculosis every year, and a large number of them lose their lives. Abdominal tuberculosis (ATB) remains common in developing countries, accounting for 0.9% to 1.95% of pediatric hospital admissions. Diagnosis of ATB in children is difficult due to the lack of specific clinical symptoms or tests and often requires invasive procedures like laparotomy or laparoscopy for a definitive diagnosis. The condition is primarily caused by Mycobacterium tuberculosis an acid-fast bacillus (AFB), though it can also result from Mycobacterium bovis or other atypical mycobacteria. ATB may occur alone or alongside extra-intestinal tuberculosis. The infection typically spreads through ingestion of tubercle bacilli or through hematogenous or local spread from other infected areas. Tissue damage occurs due to a type IV hypersensitivity reaction, where the bacilli trigger the immune system, leading to the formation of epithelioid granulomas and caseous necrosis. The most commonly affected areas in order are the ileum, ileocecal region, colon, jejunum, rectum, duodenum, stomach, and esophagus. Diagnosis is suspected on clinical findings, imaging studies and supported by serological tests or tests for identification of the AFB or its genetic material(CBNAAT). The hallmark of tissue histological diagnosis is caseating epithelioid cell granuloma, Langhans type of giant cells and identification of AFB. Medical treatment with antituberculous chemotherapy is the cornerstone of treatment. Surgical interventions are requied for diagnostic purpose like a tissue biopsy or for management of intestinal complications like perforation, obstruction or hemorrhage.