Since 1997, numerous Columbian black-tailed deer (Odocoileus hemionus columbianus) in western Washington (USA) have developed a hair loss syndrome that often preceded emaciation, debilitation, pneumonia, and death. To study this syndrome, eight affected free-ranging Columbian black-tailed deer fawns were captured from western Washington in February 1999 to determine the effect of ivermectin treatment. Fecal examinations indicated that the internal parasites were Dictyocaulus viviparus, Parelaphostrongylus sp., Trichuris sp., Moniezia sp., Eimeria spp., and gastrointestinal strongyles. Biting lice (Tricholipeurus parallelus) were observed on all deer, with up to 5 lice/cm² on the index areas counted. Three deer were treated with ivermectin subcutaneously at doses between 0.2 and 1.3 mg/kg of body weight monthly for four consecutive months, and five control deer received no anthelmintic treatment. Complete blood counts, parasite evaluations, weight gains, and hair loss evaluations were used to assess effectiveness of treatment. Two untreated deer died during the experiment compared with no deaths among the three treated deer. Treated deer gained significantly more weight (P<0.05) than the untreated deer (22.4 vs. 12.6 kg, respectively) that survived the experiment, had significantly fewer parasite eggs and larvae (P<0.05) in feces and significantly fewer nematodes (P<0.05) at necropsy, and regrew their hair at a faster rate than untreated deer. Lice and all nematode eggs and larval stages in feces were eliminated or greatly reduced following treatment. On the basis of these data, excessive louse populations, gastrointestinal nematodes, and the lungworms Parelaphostrongylus sp. and D. viviparus, might be important predisposing factors for this hair loss condition and death of affected animals.