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Isolated pancreatic tuberculosis (TB) is extremely rare, even in countries where TB is endemic. The recent increased reporting of TB of the pancreas is related to a worldwide increase in TB and an increase in emigration from countries where TB is endemic into countries where more sophisticated healthcare and diagnostic facilities are available. Herein, we report an unusual case of isolated pancreatic region TB, which presented with dyspeptic symptoms and was diagnosed by ultrasonography-guided needle aspiration and computed tomography scan of the abdomen. This case is unique with regard to abundant bacterial load, as evident by Ziehl Neelsen staining and absence of evidence of TB elsewhere. Pancreatic TB should be considered as a differential diagnosis of a pancreatic mass and most patients have an excellent clinical response to standard antituberculosis regimens.