We present a case of a 31 year-old male patient with tuberculous pericarditis with mediastinal mass that showed increased uptake on Gallium-67 image. Gallium-67 scan was performed to evaluate the activity of the superior mediastinal mass, which was detected on chest CT. A rim of intense activity around the heart was observed, but increased uptake was not seen in the mediastinum. However, on maximal contrast-enhanced SPECT images, a small focus of faint uptake was observed in the superior mediastinum. This finding implied that there was an active tuberculosis in the pericardium and inflammation in the superior mediastinal mass. This case demonstrated that Gallium-67 scinitigraphy was helpful for the diagnosis of tuberculous pericarditis. (Korean J Nucl Med 200135:280-285)