not-yet-known not-yet-known not-yet-known unknown 1 Introduction Tuberculosis (TB) remains a major global infectious disease burden, classified into pulmonary and extrapulmonary forms. Extrapulmonary TB (EPTB), which affects organs outside the lungs, is relatively uncommon in Taiwan, comprising only 5.5% of new TB cases in 2023[1]. The most frequently involved sites are lymph nodes and bones/joints; however, gastrointestinal tuberculosis (GITB) accounted for approximately only 10% of EPTB[1]. GITB predominantly affects the ileocecal region, while upper gastrointestinal involvement is rare[2]. Diagnosis is often delayed due to nonspecific symptoms and low bacterial load[3]. EUS-FNB offers a minimally invasive and effective modality to obtain tissue for diagnosis from deep-seated abdominal lesions[4]. It is crucial to improve outcomes with immediate tissue acquisition and accurate diagnosis, followed by standard anti-TB therapy.