We report the first four cases of Melioidosis treated in Iceland and review the literature. Melioidosis is caused by the saprophytic Gram negative bacteria Burkholderia pseudomallei. Most disease occurs in residents of Southeast-Asia and North-Australia. The most common presentation of Melioidosis is pneumonia but as these cases demonstrate the infection has protean manifestations and B. pseudomallei can infect nearly every organ. It is important to notify the laboratory of the possibilty of Melioidosis as the bacteria can be difficult to identify and poses an infection risk to laboratory staff. Also, B. pseudomallei is resistant to many of the antibiotics normally used to treat pneumonia and due to its intracellular persistance requires prolonged therapy.