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As TB (including extrapulmonary) has become common in Subsaharan africa due to increased prevalence of HIV, this study was done as a descriptive retrospective record reviews of patients admitted and treated for musculoskeletal tuberculosis in Nyangabgwe referral Hospital in Botswana from january 1st 2002 to december 31st 2008. It showed a significant association between musculoskeletal tuberculosis and HIV but decline in the prevalence of mTB at about the same time Botswana embraced HAART and introduced IPT to her populace. Another important finding was delayed diagnosis often resulted in more severe neurologic complication most of which however where well managed with timely and appropriate HAART and antituberculous medication.