Tuberculosis (TB) is caused by Mycobacterium tuberculosis and most commonly occurs in the lung. Only 10-15% of all cases of tuberculosis occur outside the respiratory system. Whereas secondary tuberculosis of the tonsil, where there is sputum-positive pulmonary TB, has been well documented, primary tuberculosis of the tonsil without pulmonary TB is rare, and only a few cases have been reported up to now. However, primary palatine tonsillar tuberculosis without either lung or cervical lymph node involvement has not yet been reported. The authors present a case of incidental diagnosis of primary palatine tonsillar TB following postoperative pathologic examination in an otherwise healthy 35-year-old woman who underwent bilateral tonsillectomy with endoscopic sinus surgery due to nasal obstruction and snoring. The patient received anti-tuberculosis medical treatment after tonsillectomy and was successfully treated.