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Cancers are one of the risk factors of non-tuberculous mycobacterial (NTM) lung disease. The majority of data in this group of patients concern infections caused by <i>Mycobacterium avium</i>—the most prevalent NTM species worldwide. In contrast, limited information can be found regarding the uncommon NTM such as <i>Mycobacterium szulgai</i>. We present the case of <i>M. szulgai</i> lung disease in a patient with a history of breast cancer. Coexistence of NTM lung disease and breast cancer lung metastasis as well as primary lung cancer was suspected. Finally, neoplastic disease was ruled out based on negative results of endobronchial biopsy and negative tumor markers for lung and breast cancer. <i>M. szulgai</i> lung disease was successfully treated with rifampicin, ethambutol and clarithromycin.