Background: There are various types of cutaneous drug reactions with anti-tubercular therapy (ATT), and probably each and every first line ATT can manifest these reactions. Erythema multiforme (EM) is one of the extremely rare, acute hypersensitivity reaction to various drugs including pyrazinamide. Case Report: We report a case of 19 years old female with pulmonary tuberculosis who developed biopsy proven EM 45 days after initiation of ATT, as an adverse effect of pyrazinamide. Conclusion: Physicians must be aware of this rare side effect of pyrazinamide.