Strongyloides stercoralis is a threadworm parasite with the unique capacity to complete its entire life cycle in a human host. Although asymptomatic in normal hosts, S stercoralis infection in solid organ transplant recipients is often severe, disseminated, and fatal. Risk factors for disease acquisition include travel to endemic regions. Antihelminth therapy should be instituted before transplantation for optimal clinical outcomes. Herein we review the epidemiology, biology, immune response, and diagnostic and screening strategies, as well as treatment modalities for S stercoralis in the solid organ transplant population.