The effect of intestinal flora on the establishment, development and pathogenicity of Ascaris suum larvae in piglets (Large White breed) was investigated. The infected piglets with Ascaris and Escherichia coli showed signs of pneumonia, cough with respiratory difficulties initially even though these moderated with time. They lost appetite and showed signs of unthriftiness with loss of weight. The packed cell volume was normal but the differential leucocyte counts of the pigs infected with Ascaris larvae and bacteria had high neutrophils, unlike the very high lymphocyte count observed in piglets with ascarids only. The piglets had generalized serous atrophy of body fat. The pericardial and perirenal fats were gelatinous. There was a firm and nodular grey and red hepatization with abscess pockets in the intermediate and anterior one third of the diaphragmatic lobes of the lungs. The liver contained greyish-white and depressed focus immediately dorsal to the area of attachment to the gall bladder with multifocal areas. There was no significant gross lesion in the control animals. Cultural and microscopic examinations of some internal organs of the infected animals showed that bacteria were carried to the lungs by the migrating Ascaris larvae. The combined synergistic effect of Ascaris larvae and E. coli was also investigated and it was concluded that the two agents (A. suum larvae and E. coli) worked together synergistically.