Fascioliasis is a common zoonotic infection worldwide, although cases in the United States are uncommon, sporadic, and predominantly found in the immigrant population. The small number of cases identified in the United States may reflect the unfamiliarity of physicians with this infection.A 28-year-old Hispanic woman who frequently visited northern Central Mexico presented at 36 weeks of gestation with nausea, vomiting, and right upper quadrant pain. She was diagnosed with cholelithiasis. Postpartum endoscopic retrograde cholangiopancreatography and sphincterotomy were performed, with discovery of the trematode Fasciola hepatica. The patient received triclabendazole, which led to clinical improvement.Fascioliasis often mimics another common problem in pregnancy, cholelithiasis; clinicians need to be aware of this disease in high-risk populations.