OBJECTIVE: To report an unusual case of tuberculosis with involvement laryngo-tracheo-esophageal. CASE REPORT: LOS, 59 years old, male gender, diabetes type II, with a history of 7 days of sore throat, loss of appetite and fever, no cough associated. In laryngoscopy showed edema and leukoplastic plaques the epiglottis and aryepiglottic folds suggestive of laryngeal candidiasis. No other changes to the initial clinical examination, received fluconazole and oral nystatin, which worsened after a week, and admitted for investigation. Underwent endoscopy, which showed severe ulcerative esophagitis permeated by whitish exudates, and the histopathological examination, were seen alcohol acid resistant bacilli (BAAR) and caseating granulomas. Despite the absence of pulmonary symptoms, presented with chest CT, pulmonary nodules, infiltrated "tree in bud" and mediastinal lymph node with necrotic center. A bronchoscopy was performed without showing trachea-esophageal fistula, but a tracheal ulceration in your leukoplastic area background material also positive BAAR. The final diagnosis was laryngo-tracheo-esophagic tuberculosis secondary to pulmonary tuberculosis with lymph node involvement. Treatment was initiated with isoniazid, rifampicin, ethambutol and pyrazinamide with good clinical response. CONCLUSION: Although tuberculosis of the digestive system occupy the sixth place in frequency among the cases of extra pulmonary tuberculosis and the involvement of the esophagus is rare, we must remember the possibility of the involvement of this organ in cases of laryngeal and pulmonary tuberculosis. We should also bear in mind that laryngeal atypical presentations can occur, making your clinical suspicion critical to the otolaryngologist.