Objective: To determine the prevalence of Intestinal Tuberculosis in cases of Acute abdomen. Design & Duration: A randomized prospective study from August 2019 to July 2020. Setting: Department of Surgery, VMMC & Safdarjung Hospital, New Delhi. Patients: A total number of 200 patients with Acute Abdomen, who presented as intestinal obstruction or peritonitis. Methodology: Detailed data of each patient including presentation, operative findings, procedure performed, post operative outcome and histopathology was entered on a specially designed proforma, compiled and analyzed. Results: Among the 200 patients with acute abdomen, 32 (16%) had Intestinal Tuberculosis on the basis of operative findings and histopatholoigcal reports. Age of the patients ranged between 15 to 65 years; majority (75%) were in the age group of 20 to 40 years. Male to female ratio was 1:0.45. Twelve (37.5%) patients had evidence of Pulmonary Tuberculosis as well on X–ray chest. The commonest operative findings were hyperplastic ileocaecal tuberculosis (34.3%), followed by strictures (25%), and perforations (25%). The overall mortality in cases of acute abdomen was 6% and among tubercular patients 9.3%. Conclusion: Intestinal Tuberculosis is a common problem presenting to general surgical units in the developing countries, often in an acute form. A high index of suspicion, proper evaluation and therapeutic trial in suspected patients is essential for an early diagnosis, in order to minimize complications.