Background: Cervical tuberculous lymphadenitis (CTL) is the most common form of extrapulmonary tuberculosis, presenting predominantly as painless cervical swelling. Early diagnosis is critical to prevent complications and limit disease transmission. This study aimed to evaluate the demographic, clinical, and laboratory characteristics of patients with CTL in a tertiary care hospital in Bangladesh. Methods: A crosssectional study was conducted in the Department of Otolaryngology and Head Neck Surgery, Dhaka Medical College Hospital, from January 2022 to June 2023. Ninety-six patients presenting with cervical lymphadenopathy were enrolled using purposive consecutive sampling. Detailed clinical evaluation, laboratory investigations including erythrocyte sedimentation rate (ESR), Tuberculin Skin Test (TST), fine-needle aspiration cytology (FNAC), histopathology, and GeneXpert MTB/RIF assay were performed. Data were analyzed using descriptive statistics. Results: The majority of patients (59.3%) were aged 31–45 years and female predominance (71%; male-to-female ratio 1:2.42) was observed. Socioeconomic analysis showed 44% of patients were from the poor class and 38% from the middle class; 66.7% were urban residents. All patients presented with painless cervical swelling, with additional symptoms including weakness (36.4%), fever (39.5%), weight loss (27%), cough (15.6%), and night sweats (12.5%). Lymph node involvement was predominantly unilateral (89.6%), multiple (86.4%), and measured 3
6 cm in 63.5% of cases, most commonly affecting level V nodes (56.25%). ESR was elevated in 65.6% of patients, and TST was positive in 78.1%. FNAC and histopathology confirmed TB in 64.5% and 67.7% of cases, respectively, while GeneXpert MTB/RIF was positive in 72.9%. Conclusion: CTL in Bangladesh predominantly affects young to middle-aged adults, especially females, with characteristic clinical and laboratory features. Accurate diagnosis requires an integrated approach combining clinical assessment, cytology, histopathology, and molecular testing to guide timely management and reduce morbidity.