Human parechovirus-3 (HPeV-3) infection is being increasingly identified as an important pathogen leading to neonatal sepsis-like illness. In this case report, we present a pre-term infant with striking abdominal distention whose signs and symptoms were quite similar to those of Hirschsprung-associated enterocolitis but the patient suffered from the gastrointestinal phenotype of HPeV-3 infection.© 2014 The Authors. Published by Elsevier Inc. All rights reserved.