Intramedullary tuberculous granulomas (tuberculomas) are rare in occurrence when compared to pulmonary, extra pulmonary and skeletal tuberculosis in developing countries. Here, we present clinical profile and Magnetic Resonance Imaging (MRI) findings in two intramedullary tuberculoma cases. The Magnetic Resonance Imaging (MRI) findings of intramedullary tuberculoma and its rarity in occurrence are discussed. The emphasis is on atypical presentations of intramedullary tuberculoma and the other intramedullary lesions that can closely resemble to it.