Background: The expanding clinical indications of cardiac rhythm management have led to an increased use of pacemaker implantation which is associated with increased incidence of pacemaker infections. Staphylococcus aureus and epidermidis account for the vast majority of pacemaker infections. Pacemaker infection due to Mycobacterium tuberculosis (M. tuberculosis) is very rare, only few cases having been reported till date. Methods: We describe here a study of three patients of pacemaker pocket infection with M. tuberculosis. Conclusion: The possibility of mycobacterial pacemaker infection should always be kept in mind in patients with delayed pacemaker infection.