Schistosomiasis, caused by parasitic flatworms of the genus Schistosoma, is endemic in many areas of the world. We report the case of a young male patient presenting with persistent fever, abdominal pain, vomiting and diarrhoea, with travel history to Al Baha, Saudi Arabia, an endemic area for schistosomiasis. Diagnostic imaging revealed hepatosplenomegaly and pericardial effusion. Despite negative stool and blood cultures, the clinical presentation and travel history supported the diagnosis of schistosomiasis. The patient was started on praziquantel and prednisolone therapy, resulting in significant clinical improvement. A follow-up echocardiogram one month later showed complete resolution of the pericardial effusion.