We report the first record of the medically important scorpion Tityus carrilloi in Paraguay, from the metropolitan area of Encarnación, Itapúa Department, near the Argentine border. Known for causing severe and fatal envenomings across northern Argentina, the presence of this species in southeastern Paraguay highlights the risk of cross-border dispersion. Along with the regional spread of the Brazilian Tityus serrulatus, this finding has significant epidemiological implications and underscores the urgent need for improved surveillance, diagnostics, and coordinated public health responses in Paraguay and neighboring countries, within the evolving landscape of scorpionism in southern South America.