The prevalence and incidence of American human trypanosomiasis (THAm) have declined in Latin America since the launch of regional cross-border initiatives coordinated by the Pan American Health Organization (PAHO) and the World Health Organization (1991–2004). In Europe, HAT was rarely encountered until 2004. Since 2004, 18 imported cases have been reported in the Île-de-France region (38% symptomatic, 95% from Bolivia). The challenges encountered included: availability of serological tests, accessibility of specific treatments, and the risk of mother-to-fetus transmission. The number of people from endemic areas living in France exceeds 60,000, suggesting a higher number of cases. Aside from the underestimated diagnostic challenge, the risk of vertical transmission exists in France and must be assessed. The transfusion risk has been managed since 2007 through targeted screening. (R.A.)