The paper presents an analysis of parasitological situation with paragonimiasis in Primorsky Krai over the past 30 years. In the early 1990s regular medical checkups detected paragonimiasis in 1–6% of the inhabitants of the region. Since 1996, the situation in the south of the Russian Far East has changed dramatically. Within 1–2 years, the crayfish population decreased significantly in watercourses from southern Primorye up to the Amur basin. Therefore, the incidence of the disease in population of the region has decreased to zero level since 2000. From 2014 the number of crayfish in watercourses of Primorsky Krai started growing. In 2019 the first patient with larval paragonimiasis was reported. The paper reviews the experience of the Regional Clinical Hospital of Vladivostok in treatment of 368 patients with larval paragonimiasis for the period from 1967 to 1996. On average, the disease manifested itself in 1–4 weeks from the moment of infection. The diagnosis was confirmed in 97.9% of cases via serological method. The praziquantel treatment of patients with larval paragonimiasis resulted in a cure rate of 89%. The disease duration ranged from 1–2 to 10 or more years.