A 45-year-old female presented with upper abdominal pain. Ultrasound and CECT both showed a mass in the pancreatic head and uncinate process suggestive of carcinoma of the head of the pancreas. A Whipple's pancreaticoduodenectomy was carried out. Microscopic examination showed numerous epithelioid cell granulomas in the pancreas infiltrating the duodenal mucosa. No evidence of malignancy was seen. Acid fast bacilli were positive. The patient was started on anti-tubercular therapy. Cases of isolated pancreatic tuberculosis are very rare and can mimic pancreatic carcinoma clinically and radiologically. A differential diagnosis of pancreatic tuberculosis must be made in a patient presenting with a pancreatic mass and the patient must be thoroughly investigated to confirm or rule out malignancy or tuberculosis. We herein present a case of primary pancreatic tuberculosis and discuss the clinicopathological features of this condition. We have also proposed an algorithm for the management of patients presenting with a pancreatic mass and a clinical suspicion of pancreatic tuberculosis.