An 11-year-old girl presented with severe right upper hypochondrial pain, fever, and severe pallor. Parasitological stool examination using Kato-Katz technique revealed a large number of huge operculated yellowish brown eggs. Abdominal ultrasonography revealed dilatation of the common bile duct associated with amoving shadow. Endoscopic retrograde cholangiopancreatographic sphincterotomy, basketing, ballooning, and extraction of Fasciola worms from the common bile duct were done. Key Words: pediatric, children, hypochondrial pain, endoscopic retrograde cholangiopancreatography, Fasciola (Infect Dis Clin Pract 2015;23: 99–101) Fasciola hepatica is a flat, leaf-shaped trematode. Its life cycle consists of 7 stages including egg, miracidium, sporocyst, redia, cercaria, metacercariae, and adult fluke. The parasite has 2 hosts: intermediate and definitive hosts. Mammals such as sheep, goats, and cattle are usually definitive hosts and infected by ingesting metacercaria form.1 Humans contract the disease as accidental hosts by drinking contaminated water with metacercariae; eating watercress, lettuce, alfalfa, or spinach plants; and using contaminated kitchenware.2 Fascioliasis has emerged as a significant public health problem among humans in developing countries and has been identified as one of the key neglected tropical diseases.3,4 We report an unusual case of biliary fascioliasis in a child. On review of literature, we found several adult cases of biliary fascioliasis managed by endoscopy, but only 1 pediatric case has been reported5; ours is the second case (the first case in Egypt) managed successfully by endoscopic retrograde cholangiopancreatography (ERCP).