A 38 year old woman from Dresden presented in September 2002, about four weeks after the Elbe River flooding with signs of cutaneous larva migrans on the back of her hand. There was no history of travel to tropical or subtropical regions in the last few years. Cryotherapy as well as systemic ivermectin (Stromectol) therapy were not successful in stopping progress of the lesions. Combination therapy with systemic ivermectin and topical tiabendazole (Lombristop) induced full remission. Cutaneous larva migrans normally occurs in German patients only after recent visits to tropical or subtropical regions. In our patient, however, it was most likely due to the unusual climatic conditions in the summer of 2002 in the Elbe region: Heavy rainfalls and inundation by regional rivers soaked the ground, followed by a period of unusually hot and sunny weather.