Ascaris lumbricoides is a parasitic roundworm that spreads through the faeco-oral route and is endemic in the tropics with poor sanitation. Ascariasis can cause serious abdominal complications such as intestinal obstruction, volvulus, intussusception, intestinal perforation, and hepato-biliary disease. Ultrasonography is a non-invasive and widely available imaging modality that can detect entrapped worms in the bowel or biliary tree. Early diagnosis and prompt surgical intervention can help to salvage the bowel and significantly reduce morbidity and mortality associated with such cases.