Ultrasound findings of extra-pulmonary tuberculosis (TB) have been well-described, particularly in human immunodeficiency virus (HIV) co-infected patients, and are often used as a basis of diagnosis in high-prevalence settings. Changes in findings during anti-tuberculosis treatment are less well documented. We present a single-centre case series of 21 TB-HIV co-infected individuals with typical ultrasound findings present at baseline. In 16/21 (76%) patients, all findings had resolved by month 3 of treatment. In patients with persistent ultrasound findings at 3 months, non-adherence, drug resistance, chronic disease, immune-reconstitution inflammatory syndrome and alternative diagnoses were identified. Follow-up ultrasound at month 3 may help identify high-risk cases.