Paragonimiasis is the infestation of lung flukes of the trematode genus Paragonimus. Because the symptoms and radiologic findings of paragonimiasis mimic those of tuberculosis, some patients with paragonimiasis are initially treated for tuberculosis. Although Paragonimus may also reach ectopic sites such as the peritoneum or brain, infection in the skin is rare. To our knowledge, paragonimiasis has not been found in the tip of a finger. We report a case of 39-year-old woman who was belatedly diagnosed as having paragonimiasis with a parasitic migration to the tip of the left little finger after initial misdiagnosis of tubercular serositis.