Mycobacterium abscessus lung disease, although rare, has become increasingly difficult to treat. Currently, there is no standardized treatment regimen regarding when to start antibiotic therapy and how to construct treatment regimens. In general, there has been an increased level of interest in nontuberculous mycobacterium (NTM) infections, most likely secondary to the association of NTM infection with acquired immune deficiency syndrome and recognition that NTM pulmonary infections are encountered with increasing frequency in other immunocompromised populations. With increasing prevalence, there is an increased need for standardized diagnosis and treatment. Here we discuss 3 cases of end-stage mycobacteria pneumonia in elderly women and the various treatment regimens used.