Paragonimiasis is a food-born zoonotic parasitosis caused by Paragonimus spp. Six cases of reemerging paragonimiasis within the Karan hill-tribe near the Thai-Myanmar border were evaluated to review clinical manifestations, predisposing factors, and treatment regimens. All patients tested positive for paragonimiasis eggs and presented with an array of symptoms, including chronic cough, hemoptysis, peripheral eosinophilia, and thoracic radiograph abnormalities. All fully recovered after a 2- to 5-day course of 75 to 80 mg/kg/day praziquantel. We conclude that paragonimiasis should be considered during differential diagnoses to promote early treatment and to prevent misdiagnosis of reemerging or sporadic cases. This applies particularly to endemic regions and high-risk groups known to habitually consume raw or undercooked intermediate or paratenic hosts.