Pulmonary infections range from acute pneumonia due to various bacteria and viruses to chronic infections due to mycobacterium tuberculosis and various fungi. Anaerobic gram-positive, nonspore-forming bacteria of the genus Actinomyces that affects the oropharynx, digestive tract, and genitalia cause the infection known as actinomycosis. Thoracic actinomycosis may affect the respiratory tract and the pleura, even extending to the chest wall. Pulmonary actinomycosis occurs in immunocompetent persons during the fourth and fifth decades of life, with prevalence in men and is generally due to Actinomyces israelii or A. meyeri. It is frequently misdiagnosed as primary or metastatic lung cancer or tuberculosis. The accepted predisposing factors for bronchopulmonary actinomycosis are poor dental hygiene, alcoholism and various chronic debilitating diseases, hiatus hernia, and gastroesophageal reflux. We are presenting an interesting case of pulmonary actinomycosis presenting with hemoptysis, associated with achalasia cardia and treated as tuberculosis.