&NA;Gastrointestinal tuberculosis has declined markedly in frequency since the introduction of antituberculous therapy. As a result, the diagnosis is often delayed in North American patients. Segmental colonic disease, especially in the absence of pulmonary tuberculosis, is often difficult to differentiate from Crohn's disease or a neoplasm. We describe a case of colonic tuberculosis mimicking carcinoma of the hepatic flexure of the colon.