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Tuberculosis spine presenting as isolated superior mediastinal widening is rarely seen in children. We present a 1 ½ years old child with fever and cough for a month, who was detected to have superior mediastinal widening on chest X-ray which on CT chest was found to be an extension of abscess from tuberculosis spine which had progressed anteriorly to push and compress the trachea. We report the case for its rarity and unusual presentation of TB spine.doi:10.7439/ijbar.v4i2.247 fatcat:fte6if3fg5ekbd5omwxx4yabnq