Patients receiving anti-tumor necrosis factor-α and other biologics therapy are at an increased risk of developing tuberculosis (TB); however, little is known about illnesses caused by nontuberculous mycobacteria (NTM) in this context. The aim of this study was to investigate the emergence of mycobacterial disease in Rheumatoid arthritis (RA) patients undergoing long-term anti-TNF α and other biologics therapy in real life practice. RA patients receiving biologics were recruited during two year study period between 1Mar 2014 and 28Feb2015 in a district teaching hospital. Of the 62 RA patients who received biologics therapy, two (3.23 %) developed active TB. One (50 %) patient who developed active TB had extrapulmonary involvement, while both had coexistence of TB and NTM infection. Both patients who developed active tuberculous disease were TB screen (including QFT-G test and chest X ray) negative before using biologics. The significance of this study is that the coexistence of TB and NTM infection in both of the two biologics-treated RA patients. Physicians should consider both diseases when respiratory problems develop during biologics therapy.