Mycobacterium chimaera is an environmental non-tuberculous mycobacterium belonging to Mycobacterium avium complex (MAC). It has been widely known to be associated with disseminated infection after cardiac surgery, related to heater-cooler units used during these procedures. Although M. chimaera seems to be a less virulent species compared to M. avium and M. intracellulare among MAC, several cases of M. chimaera lung infections have been reported in settings of chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, malignancy, or immunosuppression. Here, we present an Italian case report in association with newly diagnosed COPD.