Background: Tuberculous myelitis or inflammation of the spinal cord due to tuberculosis is considered a rare entity. Aims We present a case of tuberculous meningitis complicated with mielytis. Methods: A 26-year-old patient, without antecedents, was hospitalized in October 2022 for fever, comatose state, psychomotor agitation. Results: The clinical examination reveals the presence of signs of meningeal irritation and paraparesis. The CSF examination shows an important inflammatory reaction, markedly raised protein levels, the GeneXpert test was positive and the culture for Mycobacterium tuberculosis is negative. The cerebral CT examination does not show any special changes, but the MRI of the dorso-lumbar spine is suggestive of myelitis. He received treatment with antituberculosis, isoniazid (H), rifampicin (R), ethambutol (E), pyrazinamide (P), levofloxacin and linezolid for 14 days, then HRZE and methylprednisolone. The clinical evolution was favorable, after 3 months of treatment the patient is conscious, without signs of meningeal irritation, slight motor deficit in the pelvic limbs, but the inflammatory reaction and increased protein values in the CSF persists. Conclusions: Patients with myelitis often have poor outcomes. In the presented case, the patient had a favorable clinical response to the treatment, but despite the correctly administered antituberculous treatment, the inflammation in the CSF continues to persist. Further research on the pathogenesis of TB myelitis will be helpful to provide potential effective therapy to these patients.