Piperazine has been used to treat pinworm and roundworm infections for over 40 years. Piperazine-induced cerebellar ataxia, causing the dropping of objects, clumsiness, and gait abnormalities, has been infrequently reported, usually in the setting of overdose or renal insufficiency. The unusual case of an otherwise well child who developed ataxia following seven days of piperazine citrate therapy is reported.