Paragonimiasis is a parasitic lung infection caused by flukes of the genus Paragonimus, acquired by eating raw or undercooked freshwater crabs or crayfish containing the larval stage. Endemic in parts of East and Southeast Asia, West Africa, and Latin America, the larvae migrate from the gut through tissues to the lungs, where adult flukes form cysts. Symptoms include chronic cough, chest pain, and blood-tinged sputum, frequently misdiagnosed as tuberculosis. Heavy or ectopic infections can reach the brain with serious consequences. Diagnosis rests on finding eggs in sputum or stool, and praziquantel treatment is effective. Prevention is culinary: thorough cooking of freshwater crustaceans kills the parasite. The disease underscores that “raw” food traditions carry geographically specific parasite risks that travellers and importing food businesses must respect.