Endocarditis and cardiac device infection due to Mycobacterium fortuitum is a rare entity in the hospital settings. We report a case of pacemaker infection and native valve endocarditis due to Mycobacterium fortuitum, which was associated with tricuspid valve vegetation. two days after admission with fever, chills, body aches and swelling around her pacemaker, the patient's pacing system was surgically removed. The patient was then discharged at day 16 after surgery and treated with a multidrug regimen of azithromycin, levofloxacin, imipenem/cilastatin, and amikacin for six weeks followed by trimethoprim/sulfamethoxazole plus doxycycline for a further three months.