We report a case of chronic intestinal pseudo-obstruction due to a generalized visceral autonomic neuropathy in an immune-competent patient infected with Strongyloides stercoralis. The patient had immigrated to the United States from Sierra Leone in childhood but had not returned for decades. His symptoms resolved with ivermectin treatment. Clinicians should have a high index of suspicion for strongyloidiasis in any patient with abdominal complaints and a history of travel to endemic areas, even if the travel history is remote.