Nasopharyngeal tuberculosis is rare, even in endemic areas. It can be primary or secondary to pulmonary or systemic tuberculosis. Although nasopharyngeal tuberculosis represents less than 1% of all tuberculosis cases, there has been an increase in cases reported recently. The variety of presenting symptoms in nasopharyngeal tuberculosis makes it challenging to diagnose because the condition commonly mimics other pathologies. In this paper, we would like to share our experience managing three cases of rare primary nasopharyngeal tuberculosis with different backgrounds. We provide a comparison in their clinical presentations, and endoscopic and radiological features, highlighting the situations when nasopharyngeal tuberculosis needs to be considered as a differential diagnosis. A nasopharyngeal biopsy is helpful to establish the diagnosis. The patients responded well to anti-tuberculosis chemotherapy. The variation in findings proves that it is important to have a high index of suspicion in order to get an accurate early diagnosis and initiate proper treatment.