In the current report, a case in Italy of disseminated Mycobacterium avium subsp. hominissuis infection in a dog from an American lineage of Basset Hounds is described. A 2-year-old intact female Basset Hound presented with persistent lymphadenopathy, lameness, and a history characterized by coccidiosis, bacterial gastroenteritis, and alopecia. Lymphadenitis, with macrophages containing a few intracytoplasmic, negative staining, Ziehl-Neelsen-positive bacilli, was detected by a popliteal fine-needle aspirate leading to the diagnosis of mycobacteriosis. Ultrasound and X-ray examinations revealed visceral and mediastinal lymphadenopathy. Because of the extent of the disease, the dog was humanely euthanized. Significant gross abnormalities, such as enlargement of the cranial mediastinal lymph nodes with encapsulated areas of caseous necrosis and generalized lymphadenopathy, were observed at necropsy. Granulomatous lesions were histopathologically detected in the liver and spleen. Ziehl-Neelsen-positive bacilli were observed in all examined lymph node, liver, spleen, lung, and bone marrow smears. Lymph nodes and liver were collected in order to pursue speciation by bacterial culture and molecular biology; multiplex polymerase chain reaction results classified the pathogen as M. avium subsp. hominissuis. Although an immune system deficiency was not investigated, anamnesis suggests that the dog was immunocompromised. Furthermore, the dog came from an American stock of Basset Hound, and for some of this breed, a predisposition to this infection has been hypothesized.