We report the first autochthonous case of actinomycetoma in a Bedouin patient from Israel's Negev Region. The patient presented with plantar and interdigital (web) nodular lesions. The time to diagnosis from the first medical contact was 4 years, and several treatment modifications were made until a satisfactory clinical response was achieved. This case underscores the potential underdiagnosis of mycetoma in nonendemic areas, the limited data regarding optimal treatment regimens, and the need for heightened clinical awareness.