INTRODUCTIONFemale genital Tuberculosis (FG-TB) is an important but often overlooked cause of infertility.(1) However, there is paucity of epidemiological and clinical data on FG-TB.(2) Thus, FG-TB prevalence remains difficult to estimate because patients remain asymptomatic and undiagnosed.(3) Reports in developed countries like USA, Australia and Western European countries suggested an incidence of less than 1% in developed countries but up to 15 – 19% in developing countries, specifically 17% and 6 - 21% in Nigeria and South Africa respectively.(4) FG-TB is usually spread hematogenously from the lungs or through lymphatic circulation or directly through contiguous organs like the bowels to the genital regions of females.(5) Diagnosis remains challenging due to the paucibacillary nature of genital specimens and the limited sensitivity of microscopy and culture.(6) As a result, hysteroscopy and histopathology are crucial instruments for recognizing necrotizing granulomatous inflammation and detecting distinctive intrauterine alterations.(7) In Ghana, reports of FG-TB remain scarce, and documentation of hysteroscopic diagnosis is virtually absent. This case report highlights the need for increased clinical suspicion in TB-endemic areas by providing what appears to be the first Ghanaian instance of hysteroscopically suspected and histologically confirmed FG-TB in a woman presenting with infertility and amenorrhoea.