Large-scale chemotherapy has proved to be an affordable, feasible and effective strategy for the control of schistosomiasis in most endemic countries. However, it is becoming increasingly evident that chemotherapy alone has failed to break the cycle of transmission in high-risk communities, and data from Egypt confirm this. To accelerate the elimination of schistosomiasis will require more complex and integrated control strategies aimed at a permanent improvement in sanitation and living conditions in those few endemic foci where transmission is still occurring. An innovative strategy for the elimination of this disease, endemic in Egypt since the time of the pharaohs, is presented.