Background: One of the rare forms of extrapulmonary tuberculosis is female genital tract tuberculosis (FGTB), which often occurs as a result of tuberculosis spreading to the genital organs via the bloodstream or lymphatic system, with the primary lesion usually going undetected for many years. Case Presentation: A case of 68 years old female was presented, with a known case of hypertension on antihypertensive medications, who came to the emergency department complaining of abdominal distention that was evolved four months earlier, associated with loss of appetite and consequent loss of weight. CT imaging revealed mild thickening of the endometrium but with no evidence of malignancy. Hysteroscopy showed a mass-like lesion, encapsulated and well-formed, from which a biopsy was taken and sent to the histopathology, and the acid-fast bacilli special stain was identified, and diagnosed as endometrial tuberculosis. Conclusion: Endometrial tuberculosis is not a common condition in women at menopausal age. Hence, it is recommended that all patients with a positive imaging finding whether with or without vaginal losses undergo aggressive evaluation for endometrial tuberculosis. In addition, elaborative research needs to be conducted to generate further evidence-based data regarding such conditions.