We report a case of a dirofilariasis manifesting as a breast nodule in a 32-year-old Tunisian woman. It appeared as a relatively well-circumscribed and slightly dense nodule on mammography and was hypoechogenic with enhanced through transmission on ultrasonographic examination. The patient was treated by surgical resection. Histopathologic analysis could identify viable female and male worms as Dirofilaria repens. Dirofilaria is rare in Tunisia and this is the second human case reported. The patient lived all her life in Tunisia and had never been abroad.