Loiasis is a parasitic infection caused by the filarial nematode Loa loa within endemic regions of West and Central Africa. These regions include areas co-endemic for other nematode infections. Although loiasis is rarely seen in the United States (US), primary care providers who regularly see refugees from endemic areas should be aware of its clinical presentation, diagnostic work-up, and initial management. Given the challenges of diagnosing loiasis, especially in low prevalence settings, we present cases of four family members, two of whom were diagnosed with loiasis, and discuss an approach to screening populations from endemic regions during their initial Refugee Health Examination upon arrival to the US.