Tuberculosis (TB) is a major public health problem in India. Hematological parameters are useful indicators of severity in TB infection. Here, we report a case of a 15-year-old female child who came to us with severe anemia and disseminated TB (pulmonary and abdominal) with severe reactive thrombocytosis. Antitubercular drugs and broad-spectrum antibiotics (for superadded infection) were added and steroid therapy was concurrently started in view of wet type of abdominal TB. Anemia was treated with blood transfusion and hematinics and steroid therapy was gradually tapered off and then withdrawn. Treatment was monitored, and within a duration of 2-3 weeks of treatment, platelet counts showed a falling trend. The child improved clinically and symptomatically. So, she was discharged and was on regular follow-up. We are reporting this case as in this child, there are two contributing factors (anemia and TB) for thrombocytosis. We would also like to stress upon the fact that thrombocytosis can be used as a marker in TB patients, which is already known. None of the cases reported till now have such high platelet count.