Mycobacterium genavense is regarded as the primary cause of mycobacteriosis in passerine and psittacine birds kept in captivity. Mycobacterium genavense is a potential zoonotic pathogen; therefore, early antemortem detection in birds is needed. In humans, infections with M genavense are found predominantly in immunocompromised people. To investigate clinical signs and pathologic lesions and to determine the prevalence of coinfections in birds infected with M genavense, we reviewed records of 83 birds in which DNA from M genavense had been detected via real-time polymerase chain reaction. To evaluate clinical signs in birds presented as patients, results of standardized examinations of 60 birds and radiographic results from 37 birds were investigated. Necropsy results of 82 of the 83 birds were evaluated, including results of additional parasitologic, bacteriologic, and virologic examinations. Birds included in the study comprised 15 species in the orders Passeriformes, Psittaciformes, Coliiformes, Columbiformes, Coraciiformes, and Ciconiiformes. A wide range of clinical manifestations were documented, including neurologic disorders, ocular manifestations, and gastrointestinal signs. Of the 60 birds examined clinically, 15% showed no clinical signs. Coinfections with a wide range of pathogens were detected in 52% (43 of 83) of the tested birds. Coinfections included Macrorhabdus ornithogaster, circovirus, polyomavirus, avian bornavirus, adenovirus, Mycobacterium avium ssp. avium/silvaticum, Mycoplasma species, Salmonella species, Escherichia coli, Aspergillus species, and various parasites. The high number of coinfections may reflect an impaired immune status in the birds examined. These results also suggest a broad host range for M genavense, and the existence of various clinical signs that may be strongly associated with coinfections with other pathogens.