This study estimated the treatment cost of pediatric abdominal tuberculosis that potentially needs surgical treatment in India. Data were collected from 38 in-patient children at Christian Medical Hospital, Ludhiana as part of a clinical study conducted to establish the patterns of presentation and outcomes of abdominal tuberculosis in an Indian setting. A bottom-up approach was used to estimate the costs from a healthcare provider perspective, and a generalized linear model (GLM) was run to find variables that had an impact on the costs. Costs were reported in international dollars ($) and India Rupees (INR). The results show that the average direct cost was $3095.00 (standard deviation [SD]: 3480.82) or 68,065.13 INR (SD: 76,539.69). The GLM results established that duration of treatment and surgical treatment were significantly associated with higher costs. Efforts of eliminating the condition should be strengthened.