Tuberculosis (TB) is a major global public health challenge causing significant morbidity and mortality, especially in developing countries. It often affects the lungs but may also be present in other organs. Extra-pulmonary TB accounts for 25% of the cases with 10–35% detected in the head and neck region. TB of the oral cavity is a rare manifestation affecting people of all ages and its nonspecific presentation can lead to misdiagnosis or delayed diagnosis. We report a case of a 73-year-old male with a granulomatous disease presented as a nonhealing mass in the oral buccal mucosa without respiratory symptoms. Histopathologic and radiographic examinations confirmed the diagnosis. Signs of the resolution were seen after the initiation of anti-tuberculosis medications, strengthening the importance of prompt diagnosis and early treatment. Otolaryngologists are at the frontline in detecting lesions presenting in the oral cavity and can contribute to early diagnosis and correct treatment of TB of the oral cavity in unsuspecting patients. It can help reduce the burden of this contagious disease and control the potential spread of infection to both community members and healthcare workers.