Psoas abscess is a rare disorder that is often difficult to identify. The abscess may present as
back pain, pyrexia of unknown origin, groin pain that mimics a septic hip, increased frequency
of micturition, or abdominal pain. We present a case of tuberculous psoas abscess which presented
as perianal abscess besides causing a groin swelling. This presentation posed both a
diagnostic dilemma as well as management challenge. A brief review of clinical features, diagnosis,
treatment and outcome of patients with psoas abscess is presented.