A retroperitoneal Nocardia asteroides abscess was diagnosed in a 76-year-old patient. Trimethoprimsulfamethoxazole treatment for 6.5 weeks failed after surgical drainage of the abscess, and superinfection occurred. Subsequent treatment with amikacin resulted in a cure after 7 weeks. Amikacin might significantly shorten the duration of treatment in disseminated nocardiosis.