Paragonimiasis (infestation by the Paragonimus species) in Spain is a very infrequent entity within the group of imported infectious diseases. A native, resident of Equatorial Guinea who was affected by pulmonary and probably extrapulmonary paragonimiasis together with active pulmonary tuberculosis is described. This association is relatively common and may complicate the diagnostic process. The identification of the parasite was established from samples of pulmonary secretion obtained by natural expulsion and by fiber bronchoscopy in which Kinyoun carbonfucsine dye, Giemsa dye and argentic impregnation were used. The possibility of neurological disease existing (medullar and cerebral) produced by the same parasite is also discussed. Antituberculous treatment and the use of praziquantel satisfactorily control both infections.