Meningeal worm, or deer worm, is a serious health threat to alpacas. This parasitic roundworm spends part of its life cycle in white-tailed deer, where it lays eggs which are then shed onto pastures. If alpacas ingest the infective larvae while grazing, the worms can travel to their spinal cords and brains, causing neurological impairment or death. Early diagnosis is difficult, and treatment options focus on killing the parasite but cannot restore lost function. Prevention involves limiting deer contamination of grazing areas through fencing, habitat modification, population control, and pasture management. Strategic deworming, rotational grazing, and quarantine practices are also recommended. Prompt treatment is crucial to minimize permanent damage, and close monitoring is necessary.