Neck lumps are a very common presentation to hospital in paediatric patients. Lymphadenitis secondary to atypical mycobacterium infections are rare but recently there has been an increase in prevalence in the UK. The treatment of such cases is controversial; the options of medical, surgical or combination of both are practised, with variations, in different centres around the world. We report a case of a 4 year old girl who presented with a short history of a neck lump due to Mycobacterium Avium Complex (MAC) infection which was surgically excised, with good post-op and aesthetic outcome. This article aims to educate upon the background, clinical features and management of patients presenting with MAC associated neck lumps.