Strongyloides stercoralis is a common nematode causing intestinal parasitosis in the Ecuadorian population, but cases of lung infection by this helminth have not been documented in Ecuador. We document the first case of pulmonary strongyloidias is caused by S. stercoralis filariform larvae in a male patient from Manabí Province (Ecuador), showing clinical symptoms of terminal pulmonary syndrome. Previous to the decease of the patient, the larvae were identified by the direct smear method of a fresh bronchial aspirate sample collected from the patient. Hyperinfection by filariform larvae (L3) was observed, exhibiting an abundance of up to four larvae per microscopic field. We suggest that an earlier treatment of the patient with a high spectrum anthelmintic could have saved his life. Pulmonary strongyloidiasis can be under diagnosed if the parasitological analysis of wet mounts of bronchial aspirate from patients suffering of chronic bronchitis and pulmonary syndrome to investigate the possible presence of S.stercoralis is not conducted. The training for microbiological screening using classic direct methods, as well as the constant investigation of this parasitosis and other helminthiases are still vital and relevant for public health personnel and microbiologists in developing countries in order to provide an early diagnosis of underdiagnosed parasitosis.