Retropharyngeal abscess with cervical spine tuberculosis is a rare presentation of extra-pulmonary tuberculosis, which can lead to severe life-threatening complications. We report a case of a young man who presented with odynophagia and neck pain. Intraoral examination revealed cystic mass over the posterior pharyngeal wall, which turned out to be a retropharyngeal abscess secondary to tuberculosis of spine. The patient recovered with anti-tubercular treatment. We would like to highlight the diagnostic challenge faced and the management of this entity.