Tuberculosis (TB) is still an endemic disease in Malaysia.Cystic lung disease in post primary tuberculosis is notcommon. It can occur before, during or after completion ofanti-TB treatment. Clinical history and review of serial chestradiograph is paramount to make the diagnosis. This casereport highlights an interesting case of a young femalepatient who developed extensive cystic lung disease duringthe course of anti-TB treatment and the importance ofrecognizing this unusual manifestation.