Disseminated nocardiosis is rare and often late presenting infection with a mortality rate of 85% in immunocompromised individuals. Case- A 50 year old male, post-renal transplant 6 months back, on maintenance immunosuppression with tacrolimus and prednisolone, following renal transplant he had multiple episodes of urinary tract infection with multidrug resistant Klebsiella pneumoniae. The patient presented with continuous fever with chills and rigor and cough for 7 days. Computed Tomography of Thorax revealed focal patchy areas, ground glass opacity and centrilobular nodules with tree in bud pattern, calcified subpleural nodules in right upper lobe and calcified mediastinal lymph nodes. On admission blood culture was sent, it flagged on day 2 of incubation. Gram stain revealed the presence of gram positive bacteria, modified acid fast bacilli smear was positive for weakly acid fast branching, filamentous bacilli. The growth on blood culture was confirmed to be Nocardia concava, by 16srRNA sequencing. Conclusion- Radiological evidence of nodular lesions in the lungs in a post-renal transplant recipient especially within 6 months should arise a high suspicion of pulmonary nocardiosis. Nocardia must be identified upto species level by 16srRNA sequencing, as treatment varies based on the species and some of the species can be resistant to cotrimoxazole. Infection with Nocardia concava  must be treated with a combination of trimethoprim-sulfamethoxazole and linezolid.