Prevertebral abscesses are an uncommon but serious and potentially life threatening form of deep neck space infection (DNSI). DNSI can occur in any of the potential spaces within the neck and are often secondary to odontogenic or upper respiratory tract infections. We present the rare case of an extensive Tuberculosis (TB) prevertebral abscess with associated cervical spine involvement in a 32 year old immunocompetent male patient. This was definitively managed with insertion of a radiologically guided trans-cervical drain and anti-tubercular chemotherapy. The aim of this case report is to highlight an unusual case of extrapulmonary TB that was successfully treated without surgical incision and drainage. We also present an overview of the current literature.