Paragonimiasis is an infectious disease caused by ingestion of freshwater crab, crayfish, or shrimp infested with Paragonimus metacercariae. Here, we report a case of extrapulmonary paragonimiasis presenting as an abscess in the abdominal cavity. A 54 year old woman presneted, compaining of severe abdominal pain. Her abdominal CT showed an abdominal abscess with peripheral rim enhancement and central hypodensity core on omentum and terminal ileum. We decided to perfom a diagnostic laparoscopic exploration for acute abdominal pain. During surgery, we saw a living adult worm in the abscess pocket. We diagnosed paragonimiasis and treated with Praziquantel. This case was confirmed by biopsy and micro-ELISA test.