Nocardia cyriacigeorgica is a recently described species. During routine diagnostic testing of 121 clinical isolates, we found that about one fourth of the strains from Japan (19 isolates) and Thailand (8 isolates), which were identified in our laboratories as N. asteroides, in fact belong to N. cyriacigeorgica. To our knowledge, this is the first report of infection due to N. cyriacigeorgica in Japan and Thailand, and the third report of infection anywhere in the world. Although N. cyriacigeorgica is usually differentiated from other Nocardia species by utilization of glucose and gluconate, we found that it can also be differentiated by a characteristic synergistic effect between imipenem (IPM) and tobramycin (TOB).