Abstract Nontuberculous mycobacteria and Pneumocystis jirovecii pneumonia (PCP) are important opportunistic pathogens in patients with advanced immunodeficiency. We present a case of a 38-year-old male who presented with fever, cough, breathlessness, and constitutional symptoms and, on evaluation, was found to have advanced acquired immunodeficiency syndrome (AIDS), possible PCP, and mycobacteremia caused by Mycobacterium genavense. We report what seems to be the first case report of M. genavense mycobacteremia in a host with AIDS from India.