Solitary chest wall tuberculosis (TB) is rare. We report a case of primary chest wall TB in a 66-year-old woman involving the pleura and intercostal and erector spinae muscles. There was elevated FDG uptake in the right posterior chest wall. Surgery was performed, and pathology revealed inflammatory granuloma and caseous necrosis. Familiarity with 18F-FDG PET/CT images of chest wall TB could reduce possible misdiagnosis.