Pediatric gastrointestinal tuberculosis is rare compared to pulmonary TB but it has similar prevalence across all pediatric age groups. In the pediatric population only 0.3% of TB cases have abdominal involvement compared to 3% in the adult population. Cases of isolated ano-rectal TB are rarely described in case series. Although there are several reports and case series describing GI TB in Nepal, isolated ano-rectal TB has not been reported in the literature.