Nontuberculous mycobacteria are common microorganisms in nature and are particularly found in soil and water. They cause pulmonary infections, lymphadenitis, disseminated infections, localized skin and soft tissue infections, tendon-bone-articular infections, and catheter infections. Mycobacterium xenopi is categorized as a slow-growing mycobacterium. Pulmonary infections caused by M. xenopi have been found to be associated with chronic obstructive pulmonary disease (COPD), underlying diseases such as bronchiectasis, and immunosuppression. This article aims to present an atypical mycobacterial infection in a patient in whom anti-tumor necrosis factor alpha therapy was being planned and who was followed up with diagnoses of ankylosing spondylitis and COPD.