The CT findings of six patients (three symptomatic and three asymptomatic) with pulmonary paragonimiasis westermani were reviewed in correlation with the findings of radiography. Pleural changes were recognized in all cases on CT. In addition to pleural fluid collection and hydropneumothorax, which were demonstrated on plain radiograph, CT showed minimal pleural thickening and adhesion adjacent to the parenchymal lesions. CT showed round nodules of lower attenuation within a subpleural consolidation of triangular shape in two patients. Small air-filled cavities in a parenchymal lesion with central dense spots were demonstrated in two patients, and multiple cavities with irregular wall were seen in one patient. CT also demonstrated the parenchymal lesion with a tunnel-like cavity in one patient. These may represent the worm nodules, the worm within worm cysts, and the worm migration tract, respectively. These pulmonary lesions were located adjacent to the localized pleural thickening or adhesion in all six cases. CT was more useful than radiography in the diagnosis of pulmonary paragonimiasis westermani.