Fascioliasis is a zoonotic infection caused by a trematode of the liver, fasciola hepatica. The infection cycle begins in the human when aquatic vegetation or contaminated water is ingested. The clinical manifestrations can mimic most other obstructive, inflammatory, or neoplastic hepatobiliary disease. We present the case of a patient with high SUV (standardized uptake variable) at the common hepatic duct hilum area on 15F-FDG PET/CT (positron emission tomography and computed tomography). The lesion was interpreted as a hypermetabolic malignancy such as focal cholangiocarcinoma. The final diagnosis was reached by endoscopic removal of the Fasciola hepatica.