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The <i>Aspergilli</i> of section <i>Usti</i> (group <i>ustus</i>) are represented by over 20 species, of which <i>Aspergillus calidoustus</i> is the most relevant human pathogen. Invasive aspergillosis (IA) caused by these fungi is rare but could represent an emerging issue among the expanding population of patients with long-term immunosuppression receiving antifungal prophylaxis. Clinicians should be aware of this unusual type of IA, which often exhibits distinct clinical features, such as an insidious and prolonged course and a high occurrence of extra-pulmonary manifestations, such as skin/soft tissue or brain lesions. Moreover, these <i>Aspergillus</i> spp. pose a therapeutic challenge because of their decreased susceptibility to azole drugs. In this review, we outline the microbiological and clinical characteristics of IA due to <i>Aspergillus</i> spp. of section <i>Usti</i> and discuss the therapeutic options.