The meningeal worm (Parelaphostrongylus tenuis) is a parasite of white-tailed deer (Odocoileus virginianus) and is also a significant pathogen of moose (Alces alces) and other ungulates. Changes in climate or habitat may facilitate range expansion or increase the prevalence of meningeal worm infection in white-tailed deer, resulting in increased exposure to susceptible ungulates. We examined 3,730 white-tailed deer during 2002–05 to determine the prevalence and range of meningeal worm infection in North Dakota, US, and investigated whether these had changed since earlier surveys. We used multiple logistic regression to model potential effects of habitat and climate on prevalence in white-tailed deer. We also examined how habitat influences intermediate hosts by comparing gastropod abundance and microclimate among habitat types. Prevalence in deer was 14% statewide, and prevalence and geographic range had increased since the early 1990s. Natural woodlands provided the best habitat for intermediate hosts, and increases in prevalence of infection in deer may be due to recent patterns in growing-season precipitation. This study has redefined the geographic distribution of meningeal worm infection and increased understanding of how climate and habitat influence the prevalence and distribution of this parasite.