Tuberculous radiculomyelitis (TBRM) is a rare complication of tuberculosis which affects the nervous system. Common symptoms associated with TBRM include paraparesis or quadriparesis, urinary retention or constipation, and paraesthesia in the lower extremities. The ascending symptoms are often described as similar to Guillain Barre syndrome. A 21-year-old woman experienced progressive weakness from her lower to upper extremities, which eventually led to complete immobility within two days and was accompanied by autonomic dysfunction. Lumbar puncture demonstrated yellow and clear cerebrospinal fluid (CSF) with pleocytosis (214 cells/uL), neutrophil predominance (81%), increased protein (429mg/dL), and decreased CSF/serum glucose ratio (7 mg/dL vs. 159.3 mg/dL). Cervicothoracic MRI examination revealed multifocal hyperintense lesions with indistinct borders at the T5-T12 level and central predominance. These results indicate tuberculosis as the aetiology. This case illustrates the atypical manifestations of TB within the nervous system. In highly endemic countries like Indonesia, TB should be considered as one of the potential causes in the differential diagnosis of any progressive weakness involving the nervous system. The limited availability of high-sensitivity diagnostic tests for detecting Mycobacterium tuberculosis in the central nervous system remains a significant challenge.