Ascaris lumbricoides is the most common intestinal worm in the world, with highest prevalence in countries with poor hygiene and sanitation. Our study aimed to report a case of a male patient diagnosed with A. lumbricoides located at the intrahepatic biliary tree who developed sepsis due to intrahepatic abscess. Despite the high incidence of intestinal ascariasis in underdeveloped countries, ectopic forms are still rare. When hepatic abscesses are already formed, the first choice treatment is the drainage and resection of affected liver segments. This case aimed to call attention to the endemic diseases and contextualize the clinical reasoning according to the socio-economic and epidemiological situation, also emphasizing the importance of effective public health politics working in prevention and health promotion.