Background: The diagnosis of constrictive pericarditis requires a high degree of clinical suspicion due to non-specific sign and symptoms. In endemic area like Vietnam the presentation of constrictive tuberculous pericarditis is common. Here we report a case of severe calcific chronic constrictive tuberculous pericarditis. Case Report: A 25-year-old Vietnamese man presented with fatigue, progressive exertional dyspnea, ankle edema, puffiness of face, abdominal distention, non-productive cough, weight loss, night sweat, and evening fever. After physical examination and investigation, the patient was diagnosed as constrictive pericarditis. Histopathology of pericardial tissue removed via pericardiectomy confirmed the diagnosis of tuberculous pericarditis. Conclusion: A high index of suspicion for constrictive pericarditis consists of the association of signs and symptoms of right heart failure and impaired diastolic filling due to pericardial constriction. The mainstay of treatment of chronic constrictive tuberculous pericarditis is pericardiectomy and anti-tubercular therapy.