Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis, continues to be a major health problem worldwide. Primary TB infection is mostly pulmonary, but it may also occur in the lymph nodes, abdomen, skin, meninges, joints, and central nervous system. TB in the head and neck region usually occurs in the cervical lymph nodes, but is extremely rare in the temporomandibular joint (TMJ). This rarity increases the risk for not considering TB in the differential diagnosis of patients presenting with TMJ pain. This article describes an unusual case of a 53-year-old man with painful swelling in the right preauricular area accompanied by difficulty in mouth opening. After surgical exploration, histopathologic findings revealed TB in the TMJ. The findings of this case highlight the importance of considering TB in the differential diagnosis of TMJ pain, especially for patients from endemic areas, patients who have lived or visited those areas, or patients with a preauricular swelling in the TMJ area. Keywords: extrapulmonary tuberculosis, preauricular swelling, temporomandibular joint, temporomandibular disorders