Paragonimiasis is a parasitic disease of carnivorous animals caused by trematodes of the genus Paragonimus. The epidemiology and life cycle of the parasite are reviewed, including intermediate hosts, and methods of infection in human beings. The pathogenesis of human disease is outlined. The clinical symptoms, which are often cause for an erroneous diagnosis of tuberculosis in many patients with paragonimiasis, are discussed. Radiographic findings, including those on computed tomography scans, are reviewed, and examples of classic chest radiographs are presented. The common laboratory abnormalities, including those seen on pleural fluid analysis, are briefly covered. The advantages and limitations of various diagnostic procedures, including parasitological, serological and intradermal skin tests, are detailed. Lastly, current therapy, including side effects and guidelines for patient treatment, are discussed and contrasted.