Strongyloides colitis is a rare presentation of strongyloidiasis. The infection is easily curable but carries a high mortality rate if misdiagnosed oruntreated. Here, we report a case of severe Strongyloides colitis in a young Bangladeshi man, who presented with acute abdomen and peritonitis.A low index of suspicion was the main source of diagnostic delay. We believe that the high morbidity and mortality rates after misdiagnosis of this curable infection warrant efforts to increase the awareness of the disease with high index of suspicion, particularly among patients coming from endemic areas.