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The thyroid is a very rare site of presentation of primary tuberculosis or associated with miliary tuberculosis, mistaken in most of the cases with other pathologies such as thyroid cancer. Case Report: Here is described a case of primary thyroid tuberculosis with skin fistula and formation of a prevertebral abscess, in a male patient with malnutrition and alcoholism, whose diagnosis was established during the intraoperative frozen section study of hemi-thyroidectomy. Conclusion: Clinical suspicion and following a protocol including fine needle biopsy and intraoperative frozen section study is essential for the diagnosis of thyroid tuberculosis.