Extrapulmonary Tuberculosis (EPTB) can affect many organ systems, including the gastrointestinal (GI) tract. Here, it may manifest as intestinal, peritoneal, hepato-pancreato-biliary TB, or as TB lymphadenitis. We report a case of small bowel obstruction secondary to peritoneal TB deposits in a patient who had previous received BCG vaccination. The patient was managed with emergency laparotomy and received TB treatment post-operatively. This article highlights the innocuous presentation of peritoneal TB and difficulties obtaining a diagnosis. Furthermore, we review the efficacy of the BCG vaccine and remind the reader of the importance of a travel history in the acute abdomen setting.