Abstract: Tuberculous lymphadenitis remains both diagnostic and therapeutic challenge because it mimics other pathologic processes. In this study, researchers tried to find the best way for diagnosis of tuberculous lymphadenitis in Red Sea State. About 222 patients suspected to have tuberculous lymphadenitis were examined in the period from March 2008 to October 2011 in a histopathology laboratory in the Red Sea Medical center, Port Sudan, Sudan. This is the only regional laboratory to which fine needle aspiration cytology and histopathological samples were sent. Slides were stained by Papanicolaou, May-Grunewald Giemsa (MGG) and Ziehl-Neelson stains. Cultures were also done from the aspirate. Serum samples were obtained for Immuno-Chromatography Test (ICT). In 57 patients biopsies were taken and stained by Haematoxylin and Eosin (H and E). Cervical lymph nodes were the common lymph node group affected by tuberculosis (94.5%). Studied females were more than males (M:F = 1:1.2). About 94.6% of the cytology show positive result for TB. The mycobacrium grow in 88% of the culture media. Acid fast bacilli were seen in 61 patients (41.6%). Serological test was positive in 68% of the patients. So in a short facility region like the study area, FNAC remain the best method for the diagnosis of tuberculous lymphadenitis. PCR and culture may be considered in few cases whenever highly needed.