Leprosy and tuberculosis (TB) share geographic endemicity. The degree of cross-immunity of one against the other makes coinfection an uncommon clinical encounter. Here, we report a 35-year-old male patient who presented with a history of fever and cough for a month. He had ulnar claw deformity and multiple hypopigmented lesions since childhood. Chest radiograph showed left middle zone airway opacification and HR-CT revealed left lingular consolidation. Cartridge-based Nucleic Acid Amplification Test (CBNAAT) confirmed Mycobacterium tuberculosis and ulnar nerve biopsy confirmed borderline leprosy. The patient had no predisposing factors for TB other than the underlying leprosy. The dual infection was approached with WHO-recommended antitubercular treatment along with dapsone, clofazimine, and prednisolone for leprosy. Prednisolone was gradually tapered and discontinued, while the other medications were maintained. The patient's overall health showed improvement on follow-up. The possibility of concomitant leprosy and TB must be considered by the clinicians to obtain an accurate clinical diagnosis, advise a comprehensive management plan, and avoid treatment-related complications.