Abstract: Nocardiosis is often misdiagnosed and treated wrongly as tuberculosis in immunocompromised patients especially when initial presentation is pulmonary. It is because nocardiosis mimics pulmonary tuberculosis clinically as well as radiologically. Result from chest radiography is never the final diagnostic criteria for either of the conditions. Microbiological diagnosis is very important. Here, we describe the case of a patient with human immunodeficiency virus infection who was misdiagnosed and was treated primarily as tuberculosis. When the patient presented to us, his conditioned was diagnosed as disseminated nocardiosis, which was treated successfully.