A case of secondary gingival tuberculosis is presented. The case is 51 year-old male who had been suffering from undetected pulmonary tuberculosis visited a dentist because of chronic periodontal inflammation around the gingiva of the right upper and left lower molar teeth lasting for one year. The lesions remained unchanged and painful granulomatous swelling sustained in spite of the conservative treatment. The case was treated with the extraction of six teeth due to continued toothache. By pathohistological examination of gingiva and chest X-ray examination, the case was diagnosed as tuberculosis. Chest roentgenogram showed active pulmonary tuberculosis, and bacteriological examination of sputum showed tubercle bacilli. The administration of INH, RFP and EB was started, and the response to the treatment was good and the pain in the gingiva disappeared within three weeks. Secondary gingival tuberculosis is manifested as local granulomatous lesions with severe pain. The incidence of gingival tuberculosis is very rare, but we have to keep in mind that the oral tuberculosis secondary to pulmonary tuberculosis could occur.