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Pericarditis is a rare manifestation of tuberculosis. We report here the case of a 35-year-old woman admitted to clinical tamponade. The echocardiogram revealed a pericardial effusion of great circumferential abundance with significant respiratory variations and a bilateral pleural effusion of average abundance on chest radiography. The patient underwent emergency pericardial drainage. The initial tuberculosis assessment was negative. The culture of the liquid returned positive at 8 days revealing rifampicin-resistant tuberculosis (RR-TB).Therefore, examination of the pericardial fluid is useful in the diagnosis of tuberculous pericarditis. This case was considered TB-RR. The patient was put on a special treatment regimen after consensus, with good clinical improvement. Pericardial tuberculosis remains a rare disease. It is important to consider it as an etiological diagnosis, especially in endemic countries because it has a poor therapeutic prognosis. Early diagnosis would allow better management of these cases in order to limit cases of resistance.