Ascaris lumbricoides is one of the most prevalent parasitic infections, especially in developing countries. Its presence can lead to a multitude of presentations, one of the rarer ones being obstructive jaundice due to migration of the worm in to the biliary tree. We describe a case of a man who presented as an emergency to the general surgeons complaining of abdominal pain, fever, jaundice and vomiting. Ultrasound was used and the diagnosis of biliary ascariasis was made. The patient underwent surgery consisting of a cholecystectomy, common bile duct exploration and T-tube choledochostomy. Our report highlights the varied aetiology of obstructive jaundice and the importance of including biliary ascariasis in the differential diagnosis of the jaundiced patient, especially from endemic areas.