Introduction: Tuberculosis (TB) and malignancy are major public health problems in India. We often encounter circumstances where both these entities may coexist and pose a host of challenges in management. Case description: We report a case series of patients who were diagnosed with coexistent tuberculosis and malignancy and discuss the etiopathogenesis, its implications in concurrent chemotherapy, antitubercular therapy, and caveats for surgery in this subset of patients. Discussion: Tuberculosis in patients with malignancy may be more prevalent secondary to immunosuppression due to the malignancy or chemotherapy, local structural changes to the lung, local damage due to radiotherapy and common risk factors such as smoking, alcohol and poor nutrition. It may be prudent to screen for latent infection prior to initiation of systemic chemotherapy or targeted therapy. Conclusion: Disease burden of tuberculosis and malignancy, drug toxicity, compliance, surgery in TB patients, and infection prevention have to be considered to formulate a guideline for management of these patients. Clinical significance: This case series discusses a practical approach to the common scenario where the two important public health problems of tuberculosis and malignancy coexist.