Pancreatic tuberculosis is a rare clinical entity. It most often is associated with miliary tuberculosis or occurs in the immunocompromised patient and is extremely uncommon in nonendemic geographic regions. Described is a case of isolated infection of the pancreas by Mycobacterium tuberculosis occurring in an otherwise healthy individual from North America who presented with recurrent hyperamylasemia and fevers. Computerized tomography revealed a multiloculated lesion in the head of the pancreas. Intraoperative biopsies demonstrated granulomas. The diagnosis was confirmed by positive cultures. Triple drug therapy was effective in alleviating symptoms, and a follow up CT revealed a normal pancreas. One year following operation the patient remains well.