Mycobacterial infective prosthetic valve endocarditis (PVE) is an uncommon and almost uniformly fatal disease. Most reported cases involve members of the nontuberculous mycobacterium group of organisms classified as rapid growers. Presumably, infection is related to health care-associated events occurring around the time of surgery, either as a result of surgical contamination with nontuberculous mycobacterium-containing water sources or via hematogenous seeding from an infected central venous catheter. Prolonged antimicrobial combination therapy, with or without valve replacement, generally fails in eradicating the infection. We present a case of Mycobacterium abscessus PVE diagnosed approximately 2 months after cardiac valve surgery, which was necessitated by valvular insufficiency resulting from recent enterococcal endocarditis. As in the few previously reported M. abscessus PVE cases, the patient did not survive.