Meningeal worm (Parelaphostrongylus tenuis), a common nematode parasite in white-tailed deer (Odocoileus virginianus) and pathogenic for several species of ungulates in eastern North America, is not known to occur in the west. Heads of 1,902 white-tailed deer were examined for adult meningeal worm to determine geographic distribution of the parasite in Saskatchewan and Manitoba (Canada) and North Dakota (USA). Finding the parasite in a deer in eastern Saskatchewan near the Manitoba border established the current northern and western limits in Canada. Prevalence of infection was <1, 18.6, and 8.2% in Saskatchewan, Manitoba, and North Dakota, respectively. Infected deer occurred throughout southern Manitoba and eastern North Dakota. Distribution appears to have changed little since the last published survey for P. tenuis in the region in 1972. We examined precipitation, temperature, deer density, and forest cover as likely correlates to prevalence and distribution of P. tenuis. Deer management units used for hunting purposes were the scale of analysis in the three jurisdictions. Presence of P. tenuis was positively correlated with precipitation during frost-free periods and deer density, and it was negatively correlated with winter and spring temperatures. Landscapes with >25 and <75% forest cover were most likely to have infected deer. Low rainfall and low density of white-tailed deer likely influence the westernmost limit of P. tenuis.