This is the first reported case of fatal opportunistic Trichosporon asahii pneumonia in the setting of severe COVID-19 pneumonia. The patient had ventilator-requiring respiratory failure secondary to COVID-19 infection. The patient received intravenous broad-spectrum antibiotics, tocilizumab, and corticosteroids with subsequent development of cavitary infiltrates. Bronchoalveolar lavage grew T. asahii. We describe a rare complication of COVID-19 infection and describe the microbial diagnosis, possible mechanism of infection, and optimal treatment.