We report a rare case of laryngeal tuberculosis in Oman Tuberculous affection of larynx is uncommon in Oman and is rarely been reported. Tuberculosis is a chronic illness, acute clinical presentation is unusual. We report the case of a thirty One year old lady, post renal transplant with tuberculous involvement of the larynx, who presented with symptoms and clinical signs of acute epiglottitis. ENT examination showed initially a severely swollen epiglottis which turned nodular in about two weeks. The patient had been on immunosuppressive medications and glucocorticoids post renal transplant. Tuberculosis still presents sporadically in countries where the overall incidence of tuberculosis is much lower as compared to developing countries. A strong index of suspicion is needed in immunocompromised patients with suboptimal response to routine medications. Diagnostic difficulty in this peculiar situation with differential diagnosis and management of laryngeal tuberculosis is discussed along with review of literature.