In 2004-2005, approximately 13,000 refugees settled in Australia, 70% of them from Africa. Schistosomiasis is one of the many illnesses endemic in Africa and approximately 40% of refugees have been found to be infected by this parasite. It has the potential to cause serious morbidity and mortality in those who are infected and after malaria is the second most prevalent tropical disease worldwide. Australia is not known to have an appropriate snail vector and so schistosomiasis is unlikely to be a public health problem. This article presents a case that demonstrates one of the sequelae of schistosomiasis - pipe stem cirrhosis - with associated splenomegaly and oesophageal varices.