Prostatitis is a common disease, but rarely caused by M. tuberculosis. We present a case where a Danish man was referred to our outpatient clinic with lower urinary tract symptoms. Prostate biopsies revealed granulomatous prostatitis with caseous necroses and acid-fast bacilli. Urine and sputum were culture positive of M. tuberculosis and treatment was initiated. Tuberculosis is still an important diagnosis and should be remembered in urologic investigations. Extra pulmonary symptoms may be the initial presentation and lack of awareness could lead to increased spread.