Delusional parasitosis is a psychiatric illness in which patients believe that they are infested by parasites without any evidence to support this belief. Cases typically involve cutaneous manifestations. We present 2 cases of gastrointestinal delusional parasitosis, with one unfortunate fatal outcome. Our main goal is to highlight the importance of early recognition of this disease to facilitate appropriate management. Delusional infestation is considered a somatic delusional disorder, and first-line treatment involves the use of atypical antipsychotics, as recommended by the Diagnostic and Statistical Manual, 5th edition.