Mycobacterium haemophilum is a nontuberculous mycobacterium that predominantly causes disease in immunocompromised patients. Due to some similarities, especially in terms of skin manifestations to Mycobacterium leprae, disease caused by these two agents may be commonly confused with each other. Here, we describe an immunocompromised adult patient with disseminated skin lesions, prolonged cough, and progressive ocular symptoms with the initial diagnosis of leprosy but a final diagnosis of M. haemophilum infection. Clinical clues such as the pattern of skin lesions, detailed neurological examination, and concurrent involvement of other organs, combined with molecular techniques could eventually lead to the correct diagnosis.