The objective of this study was to heighten physician awareness of eustrongylidiasis by investigating the epidemiology of this parasitic infection. The nematode Eustrongylides ignotus was recovered surgically from our patient, in whom eustrongylidiasis simulated acute appendicitis. The patient had consumed two live minnows obtained from Big Timber Creek of Belmawr, NJ. The authors determined the E ignotus infestation rate of free-living minnows at this creek. With this data, they approximate the probability of human infection with E ignotus after eating live minnows and attempt to evaluate the hypothesis that eating live minnows may lead to eustrongylidiasis.