This paper reports a case of laryngeal tuberculosis in a male smoker with clinical features and similar risk factors to laryngeal cancer. The middle-aged male patient presented with odynofagia, dysphonia, dysphagia, and weight loss of 6 months' duration. Chest X-ray showed tuberculosis. Upon direct laryngoscopy, a biopsy of the vocal folds confirmed the diagnosis of laryngeal tuberculosis. Laryngeal tuberculosis must be part of the differential diagnosis of a neoplasm of the larynx because it can present with the same risk factors as smoking and drinking and cause confusion. Besides, many patients do not present with concomitant pulmonary lesions, which delays tuberculosis diagnosis and treatment as they are treated as if they had a carcinoma.