Tuberculosis (TB) remains one of the major occupational risk hazards for anaesthesiologist and health care workers in operation rooms in some of the developing countries. Anaesthesiologists do come across providing anaesthesia for patients with active tuberculosis or problems unrelated to tuberculosis like trauma and for various surgeries. As per the World Health Organization (WHO) reporting in 2013, 9 million new cases are supposed to be suffering from TB; among this 2-3% cases are found to be drug resistant. It is true that effective infection control measures and the availability of effective antibiotics for mycobacterium tuberculosis have decreased the risk of nosocomial infection. However, anaesthesiologist and the health workers in the developing countries are still at the risk of tuberculosis transmission from the patients when compared to their counterparts in the developed countries; due to the lack of adequate resources to prevent nosocomial transmission of tuberculosis. Hence, the special precautions need to be under taken by the anaesthesiologist while providing anaesthesia to these patients. From the patient point of view various drug interactions, side effects of anti-tuberculosis drugs needs to be considered preoperatively along with necessary investigations. Immune compromised patients with co infected HIV have a higher risk of developing tuberculosis.