The incidence of extrapulmonary tuberculosis is rising. The patients are predominantly immigrants and HIV-infected persons. Tuberculous lymphadenitis of the neck is the most common presentation, in the Netherlands about 200 patients a year. Fine needle aspiration with auramine/Ziehl-Neelsen stain investigation, culture and cytological examination is the diagnostic procedure of choice. If this fails to be conclusive excision biopsy is the next step. If the diagnosis is suspected on clinical, epidemiological, laboratory and bacteriological (presence of acid-fast bacilli) or cytological/histological grounds, treatment is always started, awaiting culture results. The principles for treatment are the same as for pulmonary tuberculosis. On the basis of the available literature it can be proposed to shorten the duration of treatment from 9 to 6 months.