Two cases of abdominal angiostronylosis with terminal ileum perforation are reported. The first two cases diagnosed in Panama of a well established eosinophilic granulomatous process which affects mostly children in Costa Rica. The parasite Angiostrongylus costaricensis has been demonstrated in cases with a geographic range, from Mexico down to Brazil. The parasite has been found in rodents in Panama (Sigmodon hispidus and Rattus rattus) with an still pending further epidemiological and serological studies in order to determine the true disease morbidity.