The successful management of disseminatedNocardiainfection is not well described in medical literature. Immunocompetent individuals presenting with complicated and widespreadNocardiainfection is an uncommon phenomenon. We describe an interesting case of a largeNocardiaabscess in the brain in an immunocompetent patient that was aspirated. The patient clinically improved and was discharged home on a prolonged course of intravenous antibiotics and close outpatient follow-up. He successfully finished the antibiotic therapy for one year, and repeat imaging studies suggested the resolution of the abscess. With this case, we also intend to do a brief literature analysis about the management of brain abscess caused byNocardiaspecies.