Nocardiosis remains a fairly uncommon disease in the United States. Cutaneous nocardiosis is one of many infections that can spread in a sporotrichoid pattern and therefore can be difficult to diagnose without a high index of suspicion. It is mainly caused by Nocardia asteroides and Nocardia brasiliensis, with N brasiliensis isolated in most cases of lymphocutaneous nocardiosis. We present a case of lymphocutaneous nocardiosis in a 65-year-old immunosuppressed man and review the literature.