MRI brain was abnormal in 95.7% patients in form of diffuse meningeal enhancement (68.6%), tuberculomas (57.1%), basal exudates (48.6%), perisylvian meningeal enhancement (38.6%), hydrocephalus (34.3%), cerebral infarction (28.6%) and border zone encephalitis (21.4%). Whole body FDG- PET revealed brain lesions in 74.3%. It revealed evidence of extracranial involvement in 94.1% of patients. The most common site of extracranial involvement was lung (88.6%) followed by lymph nodes (87.1%). It revealed vertebral involvement in 27.1% of patients out of whom 57.9% did not have clinical correlate. FDG-PET detected extracranial tubercular involvement in significantly higher number of TBM patients compared to conventional methods. FDG-PET showed resolution of lesions in 79.3% patients, worsening in 13.8%, while lesions remained unchanged in 6.9% of patients. FDG-PET helped in modification of treatment in all the patients who did not show resolution or worsened on follow up.