Primary inoculation tuberculosis results from the direct inoculation of Mycobacterium tuberculosis into the skin of a person who has no natural or artificially acquired immunity to the organism. The Cutaneous TB is rarely seen and accounts for only a small proportion (<1-2 %) of all TB cases. The pathogenesis requires a break in the skin due to an abrasion or injury, which allows entry of the tubercle. A 42-year-old male surgeon suffered a needle stick injury to the lateral aspect of the interphalangeal joint of the thumb of the left hand while performing a incision and drainage procedure for tuberculous arthritis of hip joint. After 4 weeks, urcerated nodule on the injured finger site persisted without lesional and systemic symptoms. Histopathologic findings showed granulomatous inflammatory infiltration and acid-fast bacilli. M. tuberculosis was identified by polymerase chain reaction. He was treated with rifampicin, isoniazid, pyrazinamide, and ethambutol for 6 months. Health care workers are at risk of direct inoculation of tuberculosis. In the case described here, an exogenous source of infection was evident, and the clinical characteristics indicated that the lesion was a primary inoculation tuberculosis. We report a typical case of primary inoculation tuberculosis, which is rarely observed.