Non-tuberculous mycobacteria (NTM) are saprophytes that are found in the environment comprising mycobacterial species other than the Mycobacterium tuberculosis complex (MTC). NTM can give rise to sporadic and epidemic forms of pulmonary and extrapulmonary infections of varying severity. Extrapulmonary disease involves lymphatic, skin/soft tissue infections, disseminated disease, and nosocomial origin post-surgery. These disease conditions mimic tuberculosis in all clinical parameters. Differentiating NTM and MTC using laboratory techniques is often challenging. More so, in isolating NTM the plausibility of it being a pathogen or a contaminant from the water source in the laboratory premises must be gauged. With the STOP TB campaign going strong it becomes imperative to distinguish NTM from MTC for proper treatment.