Primary tuberculosis of maxillary sinus is very rare. A 28 year old male patient whose medical history had no pulmonary tuberculosis, was admitted on 14 Aprill 1984, with right nasal obstruction and purulent nasal discharge for 2 years. Clinical examination showed a ill defined, dirty gray crust with surrounding yellowish discharge on posterior inferior turbinate. The crust was removed and sent for smear and culture, which revealed no organism at wet smear, many WBC at Gram stain and positive AFB staining with positive culture 1 month later. X ray examination revealed hazziness in the right maxillary and ethmoid sinus. Pathologic result revealed central caseous necrosis and surrounding chronic inflammation. AFB staining and culture of antral caseating material were positive. After surgical treatment, the patient had a course of antituberculosis regimen(INH, Rifampin and Pyrazinamide).