We study causal geodesics in the equatorial plane of the extremal Kerr-Taub-NUT spacetime, focusing on the inner-most stable circular orbit (ISCO), and we compare its behavior with extant results for the ISCO in the extremal Kerr spacetime. Calculations of the radii of the direct ISCO, its Kepler frequency, and the rotational velocity show that the ISCO coincides with the horizon in the exactly extremal situation. We also study geodesics in the strong non-extremal limit, i.e., in the limit of a vanishing Kerr parameter (i.e., for Taub-NUT and massless Taub-NUT spacetimes as special cases of this spacetime). It is shown that the radius of the direct ISCO increases with NUT charge in Taub-NUT spacetime. As a corollary, it is shown that there is no stable circular orbit in massless NUT spacetimes for timelike geodesics.