OBJECTIVE. The purpose of our study was to identify any specific CT features that may help in the diagnosis of pleuropulmonary paragonimiasis. CONCLUSION. Pleuropulmonary paragonimiasis usually manifests as a subpleural or subfissural nodule of about 2 cm in diameter that frequently contains a necrotic low-attenuation area. The constellation of focal pleural thickening and subpleural linear opacities leading to a necrotic peripheral pulmonary nodule is another frequent CT finding of paragonimiasis. Although minimal and easily overlooked, focal fibrotic pleural thickening adjacent to a pulmonary nodule can be an important clue in the diagnosis of pleuropulmonary paragonimiasis on CT.