Summary We report an unusual case of tuberculosis verrucosa cutis on the plantar aspect of the foot that had been present for more than 40 years in a 62-year-old Indian man. He had a grade IV positive Heaf test and a normal chest radiograph. Mycobacterium tuberculosis was successfully cultured from the third biopsy taken from the lesion. This case demonstrates the indolent nature of the lesion and stresses the importance of taking adequate biopsies for microbiological culture when there is a high index of suspicion for M. tuberculosis. The diagnosis of tuberculosis verrucosa cutis should be based on history and evolution of the disease, cardinal morphological features and histopathological characteristics. Response to anti-tuberculosis drugs may be of assistance.