This case report is of an immunosuppressed patient in whom a diagnosis of disseminated Strongyloides infestation was made by cytologic examination of sputum, bronchial washing and brushing although a negative bronchial biopsy was reported. For those patients receiving steroids or immunosuppressives, the important role of cytology in the diagnosis of Strongyloides stercoralis is emphasized. The morphologic characteristics of this adult intestinal nematode and the differential diagnosis are also described.