Tuberculous dactylitis is a rare extra-pulmonary manifestation common in children. Radiological and clinical presentation of tuberculous dactylitis creates confusion in diagnosis and delays treatment, which could lead to progressive joint deformity and loss of function. Two patients presented with pain and swelling of the hand accompanied with a discharging sinus in one of the patient. Radiologically both patients presented as a lytic lesion without any evidence of a primary foci. Culture and microscopic examination confirmed tubercle granuloma in the lesion. Both patients were started on anti-tuberculosis drugs and one patient underwent ray amputation. At final follow up, both patients had good hand function.