We describe a case of syngamosis in a 43-year-old Italian tourist presenting with chronic cough and episodes of haemoptysis upon return from the Caribbean. The patient underwent many diagnostic procedures and was repeatedly, yet unsuccessfully, treated (for asthma, bronchitis and gastro-oesophageal reflux disease) before the correct diagnosis was reached. During a fibre optic bronchoscopy a Y-shaped red object was extracted from the airways and identified as a pair of Mammomonogamus laryngeus. After this procedure the patient improved, although a dry cough persisted and two other minor episodes of haemoptysis occurred. The patient was treated with anti-helmintic drugs and recovered after 3 months.