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Nontuberculous mycobacteria (NTM) are ubiquitous in nature and most commonly cause pulmonary infections and cervicofacial lymphadenitis in children. Here we report a rare case of NTM mastoiditis in a 3-year-old immunocompetent patient who presented with left mucoid otorrhea refractory to two months of ciprofloxacin/dexamethasone drops. The patient underwent left cortical mastoidectomy and treatment with 7 months of triple antibiotic therapy. Infection remained localized to the middle ear with signs of resolution. Early bacterial culture with acid-fast bacilli staining should be considered in immunocompetent patients presenting with refractory otorrhea.