Infections are the leading cause of morbidity and mortality during the early posttransplant period. Of these infections, pulmonary infections are the most serious. Bacteria are the leading pathogen, followed by various opportunistic pathogens, such as cytomegalovirus (CMV) and mycobacterium tuberculosis. This investigation describes a 52-year-old male with a rare coinfection of CMV pneumonitis and miliary tuberculosis, 2 months after renal transplantation. This is the first case report of a coinfection with cytomegalovirus and Mycobacterium tuberculosis presenting with diffuse pulmonary miliary lesions.