Mycobacterium abscessus is a highly antibiotic-resistant rapidly growing mycobacteria. We present the first documented case of total hip arthroplasty infection caused by Mycobacterium abscessus and our experience using tigecycline after first-line therapies failed to eradicate the patient's infection. Tigecycline is a new broad-spectrum antibiotic typically used in complicated skin and intra-abdominal infections. Our report highlights the benefits and difficulties of prolonged tigecycline use. This is the first documented curative treatment of M. abscessus infection of any type of prosthetic joint and also the first successful use of tigecycline to treat a rapidly growing mycobacteria prosthetic joint infection of any species in the literature.