This report describes a unique case of an 89-year-old-male who presented with a right psoas abscess and new erosive changes in the L3/L4 vertebral bodies. This is on a background of non muscle invasive bladder cancer (NMIBC) for which he received intravesical Bacillus Calmette-Guerin (BCG). Pott's disease is a rare complication of BCG therapy and there is paucity of data about the risk factors for systemic spread of intravesical BCG.