Asian countries including Korea, Japan, China, Taiwan, and Philippines are endemic area of Paragonimiasis as people who live those countries have special diet habbit to ingest raw fish and meat. Of the Paragonimus westermani infestation, mediastinal paragonimiasis is a rare condition because of its life cycle. We experienced a case of mediastinal parasitic cyst resected under video-thoracoscopy, which was confirmed as paragonimiasis granuloma postoperativley.[KTCS 1993;1:67-70]