Fibrosing mediastinitis (FM) is a rare benign disorder caused by proliferation of acellular collagen and fibrous tissue within the mediastinum. In the United States, most cases are thought to be caused by an abnormal immune response to Histoplasma capsulatum infection. Some cases of FM are related to tuberculosis. In most patients the cause of FM is unknown. The affected patients are typically young and present with signs and symptoms of obstruction or compression of the superior vena cava, pulmonary veins or arteries, central airways or esophagus. Computed tomography and magnetic resonance imaging are central to the diagnosis and management of this disorder. We present a rare case of FM as a sequela of tuberculosis.