The protean manifestations of tuberculosis include multifocal spinal tuberculosis involving uncommon spinal segments such as the lumbar spine, sacrum and coccyx. Another uncommon presentation is the concomitant occurrence of appendicular skeletal lesions with vertebral involvement. Placing impetus on the need for a high index of suspicion for these rare manifestations, we present an unusual case of multifocal skeletal tuberculosis involving all the segments of the spine (cervical, thoracic and lumbar spine, sacrum) along with lesions in both iliac bones, left hip and sternum in an immune-competent adolescent female patient.