Tuberculosis associated sepsis shock is very rare case due to the difficultly in establishing a diagnosis and finding the underlying disease. A Woman 55 years old with Tuberculosis and sepsis shock hospitalized Wangaya General Hospital, Denpasar, Bali. The patient was consulted to an internist with complaints of weakness, nausea and low intake, five times had diarrhea , three weeks for a cough. Patients has a positive bakteriologis .Patient has a history of AIDS on treatment with ARV, , a history of a lump in the right neck since 1 month ago and a fine needle aspiration biopsy (FNAB) was carried out with the results in the form of a cytomorphological picture that suggested a focus of atypical cells with a background of suppurative chronic inflammation. The results of the physical examination revealed fever (380C), blood pressure 78/46mmHg, pulse rate 110x/min. Laboratory results obtained WBC: 2.60, HB: 7.5, HCT: 23.3, Plt: 353, SGOT/SGPT: 68/8, GDA: 142, BUN/SC: 108/2.6, Na: 141, K: 2.7, Cl: 107, thorax x-ray results showed signs of Miliary DD TB/ Metastatic. Tuberculosis associated sepsis shock is very rare case due to the difficultly in establishing a diagnosis and finding the underlying disease. A Woman 55 years old with Tuberculosis and sepsis shock hospitalized Wangaya General Hospital, Denpasar, Bali. The patient was consulted to an internist with complaints of weakness, nausea and low intake, five times had diarrhea , three weeks for a cough. Patients has a positive bakteriologis .Patient has a history of AIDS on treatment with ARV, , a history of a lump in the right neck since 1 month ago and a fine needle aspiration biopsy (FNAB) was carried out with the results in the form of a cytomorphological picture that suggested a focus of atypical cells with a background of suppurative chronic inflammation. The results of the physical examination revealed fever (380C), blood pressure 78/46mmHg, pulse rate 110x/min. Laboratory results obtained WBC: 2.60, HB: 7.5, HCT: 23.3, Plt: 353, SGOT/SGPT: 68/8, GDA: 142, BUN/SC: 108/2.6, Na: 141, K: 2.7, Cl: 107, thorax x-ray results showed signs of Miliary DD TB/ Metastatic.