Disseminated Mycobacterium scrofulaceum infection has rarely been reported, and the majority of infections have been associated with AIDS or other immunocompromising diseases. We describe a previously healthy man with M. scrofulaceum infection whose clinical manifestations included miliary lung lesions, mediastinal lymphadenitis, granulomatous hepatitis, osteomyelitis, subcutaneous abscesses, and probable renal involvement. M. scrofulaceum was isolated from multiple specimens of sputum, urine, and the abscesses. The patient was treated successfully with the combination of isoniazid, ethambutol, rifampin, and ofloxacin. To our knowledge, this is the first detailed description of an extensively disseminated infection due to M. scrofulaceum in an immunocompetent host since the advent of AIDS.