Mycobacterium chelonae is a rapidly growing mycobacterium (RGM) in Runyon group IV. This group includes all other nontuberculous mycobacterium (NTM) except the mycobacterium tuberculosis complex. The most commonly infected organ by RGM is the lung, usually in immunosuppressed patients or those with underlying lung disease. Vertebral infection is very rare. Osteomyelitis is rarely caused by M. chelonae, and only one other case of M. chelonae vertebral osteomyelitis has been reported. A case of M. chelonae vertebral osteomyelitis in a man with intravenous drug abuse is reported, and NTM osteomyelitis is reviewed with a focus on M. chelonae and appropriate treatment options for M. chelonae vertebral osteomyelitis.