Addison's disease (AD) was first described in 1855 by Thomas Addison, a physician and medical researcher. Previously, tuberculosis (TB) was a frequent cause of AD. There has been a decrease in adrenal TB as a result of antimicrobial chemotherapy. Adrenal TB involves bilateral glands more frequently due to hematogenous spread. Due to the obscure symptoms, it is often onerous to diagnose acute adrenal insufficiency. Patients usually present with severely reduced blood pressure, shock, acute onset abdominal pain, fever, and even vomiting. Chronic insufficiency presents with complaints of fatigue, decreased muscle strength, and irritability. Computerized tomography (CT) scan and magnetic resonance imaging (MRI) are useful in differentiating tubercular AD from other potential causes of adrenal insufficiency. Treatment involves antitubercular treatment (ATT) as well as maintenance steroids, as rifampicin, which is a part of ATT, is a potent cytochrome P450 enzyme inducer, lowering the adrenal reserve. A 37-year-old male presented to the hospital with complaints of cough and intermittent fever with evening rise in temperature for 6 months. He had tachycardia, hypotension, high-grade fever, along with unintentional weight loss and fatigue. Investigations reduced serum cortisol, sputum showed the presence of acid-fast bacilli. The patient was initiated on oral steroids and antitubercular therapy. The patient's overall symptoms improved and he was discharged with the same.