Introduction: Tuberculosis rarely occurs in the upper respiratory tract, however, unrecognized and without treatment can lead to disabling complications and remains an epidemiological threat.

Objectives: The aim of the present study is to illustrate the clinical and imaging presentations of upper respiratory tract tuberculosis to avoid pitfalls in diagnosis and provide early treatment.

Methods: We retrospectively reviewed the clinical records of patients diagnosed with tuberculosis of the upper respiratory tract in our department between 1990 and 2022.

Results: We have collected 14 patients (9 males and 5 females). The average age of patients was 47 ± 18,8 years. The most commonly involved structure was the nasopharynx (6 cases) followed by the larynx (5 cases), oropharynx (2 cases), and paranasal sinus (1 case). Pulmonary tuberculosis was identified in 5 cases. The most common symptoms were nasal obstruction in nasopharyngeal and sinonasal tuberculosis (3 cases), horseness in laryngeal tuberculosis (5 cases), and sore throat and dysphagia in oropharyngeal tuberculosis (2 cases). A mass-like lesion mimicking a tumor was found on the computed tomography in six cases. The mean duration of antituberculous chemotherapy was 10 ± 2 months. A successful outcome of the treatment was achieved in all cases with a follow-up period of 2 to 6 years.

Conclusions: Tuberculosis of the upper respiratory tract has non-specific clinical presentations and imaging appearances. It should be taken into consideration in the differential diagnosis of upper respiratory tract lesions. Early diagnosis and treatment can significantly improve the patient's quality of life and reduce disease transmission.