Mycobacterium abscessus granulomatous cystitis is exceedingly rare in the literature. However, M. abscessus is the most pathogenic of the rapidly growing nontuberculous mycobacteria (RGM) that is known to cause pulmonary disease, cutaneous infections, and other nosocomial infections. The diagnosis of nonpulmonary disease is made by tissue biopsy or culture. The various nosocomial infections caused by rapidly growing mycobacteria include catheter-related prosthetic devices and surgical site infections.We present the case of a 73-year-old man with superficial bladder cancer, who developed M. abscessus granulomatous cystitis after cystoscopic tumor resection and intravesical bacillus Calmette-Guérin infusions. The patient was successfully treated with levofloxacin and azithromycin.