A 26 year old woman with history of primary infertility presented with abdominal mass. Diagnostic investigations were suggestive of an ovarian malignancy. Postoperatively, coexisting tuberculosis and endometriosis were diagnosed on the basis of histopathology. Tuberculosis was confirmed by polymerase chain reaction and culture growth for Mycobacterium tuberculosis. The patient was given complete treatment for both the diseases. Symptomatically, the patient has improved but has not conceived spontaneously after nine months of surgery. This case is the first documentation of coexisting tuberculosis of endometrium, fallopian tube and ovary with tuberculosis also present in the endometriotic foci. Fecundity of the female declines to a greater degree due to presence of dual pathologies which affect fertilisation by independent different pathogenic mechanisms.