A 34-year-old renal transplant recipient developed multiple soft tissue and extensive cerebral nocardiosis. The number and location of the cerebral abscesses and probable areas of cerebritis precluded surgical drainage procedures. Gradual resolution of all the cerebral lesions occurred over a period of 6 months with antibiotic therapy alone. A review of the literature revealed only one previous case of a patient with pulmonary nocardiosis who had a probable secondary brain abscess and who survived without surgical drainage. Thus, if surgical drainage is not possible, antibiotic therapy alone may offer a hope of survival in what otherwise has been considered a uniformly fatal disease.