Aim: To define the endoscopic features and distribution of colonic tuberculosis (CTB) and Crohn’s disease (CD) for early diagnosis. Methods: All adult patients referred for colonoscopy for CTB and CD was included. Demographic and colonoscopy features were recorded and biopsy taken. Results: Ninety patients, of which 48 in CTB were enrolled. In CTB, lesions were mainly located on the right colon and ulcers were single or three to five, size more than 5 cm, irregular in shape, yellow glistening in color, circumferentially oriented, border indistinct with nodular component. CD involved both side of the colon and ulcers were more than five in number, linear or oval in shape, less than 2 cm, longitudinal orientation, dirty yellow color and intervening mucosa contain aphthous ulcers or cobble stoning Conclusion: Colonic tuberculosis and Crohn’s disease has distinct endoscopic and distribution pattern with some overlap. Colonoscopy and biopsy is an important diagnostic tool for early diagnosis in CTB and CD.