Objective: To evaluate the incidence, treatment and clinical outcomes of tuberculous (TB) lymphadenitis at Penang General Hospital, Malaysia. Materials and Methods: Penang General Hospital is the referral center for all tuberculosis patients in the state of Penang. Patient records were reviewed to identify patients with confirmed diagnosis of TB lymphadenitis between January 2006 and December 2008. Data were analyzed using SPSS version 15. Results: Of 1,548 tuberculosis cases, 109 (7.0%) patients had TB lymphadenitis. The mean age was 36.4 ± 12.87 years and of the 109 patients with TB lymphadenitis, 35 (33.0%), 37 (34.0%) and 36 (33.0%) were observed for 2006, 2007 and 2008, respectively. Ethnically, 45 (41.3%) were Malay followed by 37 Chinese (33.9%). Among risk factors for TB lymphadenitis, HIV and diabetes mellitus were seen in 17 (15.6%) and 11 (10.0%) patients, respectively. Cough and fever were the most frequently reported symptoms. In a majority of cases (n = 90, 82.5%) positive results were obtained for fine-needle aspiration (FNA). Directly observed therapy was given to all patients. Sixty-two (56.9%) patients were successfully treated, and 5 (4.6%) patients died during the treatment. Conclusion: There was no increase in the incidence of TB lymphadenitis over the 3-year study period. The incidence was slightly higher in male than female gender and in Malay (ethnic group). Diabetes mellitus and HIV were the most commonly reported risk factors. FNA is the most reliable diagnostic test.