Objective: To summarize the clinical characteristics, diagnosis and surgical treatment of tuberculosis of large bowel. Methods: The clinical data of 22 patients with tuberculosis of the large bowel admitted to our hospital were retrospectively analyzed. Results: Female patients accounted for the majority of the whole group. The ages of the patients were from 19 to 76 (average of 44.5±10.5) years and the misdiagnosis rate before surgery was 72.7% (16/22). The main clinical manifestations of the patients were abdominal pain, abdominal mass, and stool-habit alteration. The gastrointestinal contrast examinations, and colonoscopic and laparoscopic biopsies were helpful for the detection of this disease, and the definite diagnosis mainly depended on the pathological finding. Due to misdiagnosis or complications, 22 patients underwent resection of the affected bowel segment, ileocecal resection or right hemicolectomy, adhesiolysis, abscess evacuation and exploratory operation respectively, and the patients were treated with postoperative combined anti-tuberculosis treatment for 6 to 24 (average of 8.2±5.3) months. All patients were followed up for 6–120 (55.8±15.5) months, of whom 19 were cured and 3 had symptomatic improvement. Conclusion: Tuberculosis of the large bowel has a high rate of misdiagnosis, so the surgical interventions are performed usually because of misdiagnoses or for complications. The selection of the surgical timing and procedure is important for these patients.