Tetralogy of Fallots’ (TOF) is the commonest cyanotic congenital heart disease. In this modern era when we are doing minimally invasive cardiac surgeries (MICS) and Robotic surgeries it is quiet uncommon to see a tetralogypresenting at the age of 42 years for intra cardiac repair (ICR). We are reporting a case of adult TOF with destroyed lung (post tubercular) who presented to us with severe breathlessness. We did intracardiac repair and successfully managed the case. Tetralogy of Fallots presenting at 42 years is relatively uncommon. TOF with destroyed lung is again a rarity. By our case report we want to give message to surgeons and cardiologist that TOF can present with tuberculosis and destroyed lung at this stage also and can be operated and successfully managed and will be benefited by surgery.