Strongyloides stercoralis is a unique parasite. It can complete its life cycle entirely within the human host and set up autoinfection cycle. As long as there is an intact immune system, the host can control the parasitic burden, and the organism may persist for years. When cell-mediated immunity becomes impaired, the parasite burden will grow, disseminate, and cause hyper infection. We report a case of pulmonary strongyloidiasis in a Chronic obstructive pulmonary disease patient who presented with acute exacerbation of breathlessness and productive cough. Sputum cytology and stool wet smears showed Strongyloides stercoralis larvae. Clinical improvement was achieved with Albendazole and Ivermectin treatment. This case emphasizes the importance of maintaining a high index of suspicion for the diagnosis of pulmonary strongyloidiasis in non endemic areas and also the possibility of presentation even without peripheral blood eosinophilia.