Human infection with the sheep liver fluke Fasciola hepatica is a global zoonosis that usually parallels the prevalence of infection in sheep and other ruminants. The disease is endemic in South and Central America, Puerto Rico, the Caribbean region, many parts of Africa, Asia, the Middle East, Australia, and China. There have been a number of focal outbreaks reported from Europe, including southern France and the Mediterranean region. Since acute fascioliasis has rarely been reported in the United States, physicians in this country frequently overlook the diagnosis. Therefore, we report a case of acute human fascioliasis and review the pathogenesis, diagnosis, and treatment of this disease in a recently arrived immigrant.