The incidence of pulmonary nontuberculous mycobacterial disease is increasing. Despite aggressive medical therapy, a subset of patients will experience treatment failure or suffer disabling or life-threatening symptoms. The use of anatomic lung resection in addition to optimal medical management may, in select cases, result in improved clinical outcomes. More data are needed to confirm this approach. For those with nontuberculous mycobacterial infection, treatment in a multidisciplinary setting including surgeons familiar with operative techniques specific to infectious lung disease will improve patient care.