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Tuberculosis is a major scourge, posing a serious public health problem in countries where it is endemic. Osteoarticular involvement accounts for 3 to 5% of all tuberculosis cases and 10 to 15% of extrapulmonary tuberculosis cases. We report a case of tibial osteitis caused by Mycobacterium tuberculosis in a 52-year-old female patient who presented to the trauma department at the Mohammed V Military Teaching Hospital with a painful swelling of the lower part of her left leg. Standard X-rays and computed tomography (CT) scans revealed bone involvement, specifically in the tibia. In an endemic context, any persistent and atypical bone lesion should raise suspicion of osteoarticular tuberculosis to enable rapid diagnosis and appropriate therapeutic management. In the absence of other suggestive pulmonary or extrapulmonary lesions, the diagnosis also relies on the exclusion of other pathologies, such as malignant tumors, which may present with similar clinical and radiological features.