Laparoscopic Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric surgical procedure with successful outcomes. RYGB has multiple positive outcomes, including sustained weight reduction, resolution of co-morbidities and improvement in the overall health. RYGB has many complications like any other surgery, but the development of tuberculosis (TB) either pulmonary or extra-pulmonary secondary to RYGB is very rare. We present a 32-year-old female with the history of a successful RYGB three years ago, who presented with signs and symptoms of possible TB which was later confirmed with sputum acid-fast bacilli and sputum culture. She was treated with anti-tuberculosis treatment (ATI') drugs for six months with complete resolution of her symptoms. We recommend raising awareness in the health care professionals about this rare complication of RYGB in the need of time.