The necrotizing scleritis and recurrent erythema nodosum, two clinical entities difficult to diagnose and which represent a challenge to the physician. Tuberculosis produces both processes by an immune reaction of delayed hypersensitivity type IV to various antigenic components of mycobacteria. Most tuberculosis patients have no ocular history of pulmonary or systemic disease in up to 50 % and no evidence of pathology in the chest radiograph. An adequate treatment leads to a favorable prognosis. It occurs when the diagnosis of infection is made on time. We describe the case of a woman with necrotizing scleritis associated with recurrent erythema nodosum secondary to infection with Mycobacterium tuberculosis complex.