The case of a 48-year-old man with pulmonary paragonimiasis mimicking lung cancer on positron emission tomography with fluorodeoxyglucose (FDG-PET) imaging is reported herein. Plain radiography and computed tomography (CT) of the chest showed a nodular lesion at the left pulmonary hilum. Lung cancer was strongly suggested from standardized uptake values determined on FDG-PET imaging; however, repeat chest CT revealed the lesion to have decreased in size. Pulmonary paragonimiasis was subsequently diagnosed after sputum microscopy demonstrated operculated parasitic eggs. To the best of our knowledge, this is the first reported case of pulmonary paragonimiasis mimicking lung cancer on FDG-PET imaging.