The objective of this article is to report an illustrative case of tuberculous meningitis in pregnancy and review the recent literature outlining management and outcome of this devastating disease. A MEDLINE database search for English and French language articles dating back to 1966 was conducted and supplemented by reviewing the references of key articles and textbooks. An article was included if it described a case of tuberculous meningitis during pregnancy or explained the management of this disease. The search yielded a total of 17 articles, case reports, and reviews relating to tuberculous meningitis and/or pregnancy. Six authors describe cases and outcomes of tuberculous meningitis during pregnancy to give a total of 55 cases. Twenty-one patients died of their disease (38.2%), while 15 fetal or neonatal deaths have been reported (36.6%). Tuberculous meningitis is an insidious disease presenting a diagnostic challenge to even an astute practitioner. When recognized early and treated effectively with modern antituberculous medication, prognosis for mother and child is greatly improved.