Trichuris trichiura infection has become rare in Taiwan due to decades of public health improvements, yet it remains prevalent in many tropical countries. As global workforce mobility increases, primary care physicians may increasingly encounter imported parasitic infections in asymptomatic individuals. This case illustrates a scenario relevant to routine health examinations and emphasizes the role of family physicians in early detection, risk assessment, and patient counseling.A 53-year-old Taiwanese man underwent a self-paid health check-up after several years of employment in the Philippines. He denied gastrointestinal symptoms. Screening colonoscopy revealed a slender, motile worm attached to the ascending colon mucosa. Endoscopic removal was performed, and histopathology confirmed T. trichiura through characteristic nematode morphology and barrel-shaped eggs with bipolar plugs. Laboratory tests, abdominal ultrasonography, chest radiography, pulmonary function testing, and esophagogastroduodenoscopy showed no infection-related abnormalities. The patient received mebendazole 100 mg twice daily for 9 days. Stool testing was recommended but not completed due to loss to follow-up.Although T. trichiura infections are well described, incidental detection in a low-prevalence region, coupled with comprehensive evaluation in an asymptomatic adult, provides a unique clinical perspective relevant to family medicine. The case highlights how opportunistic screening—common within general practice health check programs—can reveal imported infections even in individuals without symptoms.This case underscores the critical importance of detailed travel and occupational histories during routine primary care visits. It also illustrates the challenges in ensuring patient adherence to follow-up when symptoms are absent. The case encourages clinicians to maintain clinical suspicion for parasitic infections in returning workers and to develop practical strategies to enhance follow-up testing and treatment verification.Colonoscopy provides both diagnostic and therapeutic utility in intestinal helminthiasis. Extended mebendazole regimens may improve eradication rates but require stool confirmation. As international mobility rises, clinicians in low-prevalence countries must anticipate re-emerging parasitic diseases.This case offers transferable insights for general practice, demonstrating the value of thorough history-taking, appropriate use of screening tools, and proactive management of asymptomatic imported infections in primary care.