A case of cutaneous Mycobacterium kansasii infection is reported, and 28 similar cases are reviewed. Cutaneous infection may resemble sporotrichosis and is often associated with systemic illness, immunosuppression, skin pathology, or contact with contaminated water. Immunosuppressed patients with M. kansasii infection may present with atypical clinical features (such as cellulitis and seroma) and atypical histology (absence of granulomas), which may delay diagnosis and effective treatment. The incidence of disseminated M. kansasii infection, which has a worse prognosis, is higher among immunosuppressed patients. When M. kansasii infection is confined to the skin, the disease is usually indolent. Chemotherapy with a variety of agents, including traditional antituberculous agents as well as erythromycin, minocycline, and doxycycline, has been successful, although in vitro resistance to isoniazid and p-aminosalicylic acid is common. Reducing the dose of corticosteroids may be a beneficial adjunct to therapy for M. kansasii infection.