Extrapulmonary tuberculosis is the tuberculosis of the organs other than lungs, caused by mycobacterium tuberculosis It is endemic in Kingdom of Saudi Arabia [KSA] especially in Makkah as Asian / Southeast people are more here. Experimental study. This study was conducted at King Abdul Aziz Hospital Makkah during 1 [st] Jan 2007 to 31 Dec.2008. In our study 13 cases where examined, diagnosed [by both imaging and laboratory work up] and treated for extra pulmonary tuberculosis in King Abdul Aziz Hospital, Makkah. Diagnosis of extra pulmonary tuberculosis is often difficult especially where lungs are not involved Radiological findings especially C T were of great help in the diagnosis of extra pulmonary tuberculosis Final diagnosis was made by histopathological examination and culture for most of the patients Predominantly [82%] two systems were involved 44% lymphadenopathy, mainly cervical and mediastinal while musculoskeletal system was involved [with involvement of vertebrae and paraspmal muscles] in 38% Diagnosis of extra pulmonary tube culosis requires high clinical suspicion, different imaging work up and special staining / culture media for diagnosis of mycobacterium tuberculosis bacilli [acid-fast bacilli]. Patient’s delay [average 2 months] and Doctor’s delay time [average 7 days] was also observed in individual cases Various patterns of extra pulmonary tuberculosis [EPT] in Makkah in Saudi and Non Saudi patients also compared with other parts of KSA by reviewing the literature The results showed that disease pattern has changed along with increase incidence rate of EPT in KSA over the last few years True rates may be higher as there may be incomplete reportmg or the patients may be referred to other areas of Kingdom. The clinical and radiological features of extra-pulmonary tuberculosis may clue to the diagnosis as many other diseases can mimic the imaging. The patterns of extrapulmonary tuberculosis may vary due to extent of disease involvement otherwise inclination of region involvement is same everywhere. Extrapulmonary tuberculosis is relatively less in Saudi patients [from 1: 2 to 1: 3 depending upon regions] as compared to non Saudi patients