We report a case of ano-rectal tumour clinically diagnosed as cancer in a 36 years old male AIDS patient. Pathology analysis of the biopsy specimen revealed tuberculosis. The tumour regressed enormously and the general condition of the patient improved during the follow upwith anti-tuberculous and ARV therapy. Not all tumour-like lesions that occur in immune depressed patients are neoplasia. This is a case of a rare localization of a common diseaseand highlights the importance of pathology analysis of specimens in diagnosis and management of patients even when clinical presentation of the case appears so obvious.