The eggs of Diphyllobothrium nihonkaiense were reported to be smaller than those of the classical Diphyllobothrium latum in general. However, verification using a large number of adult tapeworms is required. We assessed the egg size variation in 32 adult specimens of D. nihonkaiense recovered from Korean patients in 1975-2014. The diagnosis of individual specimens was based on analysis of the mitochondrial cytochrome c oxidase 1 gene sequence. Uterine eggs (n = 10) were obtained from each specimen, and their length and width were measured by micrometry. The results indicated that the egg size of D. nihonkaiense (total number of eggs measured, 320) was widely variable according to individual specimens, 54-76 μm long (mean 64) and 35-58 μm wide (mean 45), with a length-width ratio of 1.32-1.70 (mean 1.46). The worm showing the smallest egg size had a length range of 54-62 μm, whereas the one showing the largest egg size had a length range of 68-76 μm. The two ranges did not overlap, and a similar pattern was observed for the egg width. Mapping of each egg size (n = 320) showed a wide variation in length and width. The widely variable egg size of D. nihonkaiense cannot be used for specific diagnosis of diphyllobothriid tapeworm infections in human patients.