In this case report, a severe infection with Sarcoptes scabiei in llamas is described. Sarcoptic mange is common in small camelids, but is often detected too late. In this case, the llamas showed severe signs of pruritus, hyperkeratinization, alopecia and pyodermy. Psoroptes mites were found in the ear and an otitis was present. One llama died and showed an abcedation of the ear base. A treatment with doramectine S.C. in combination with a topical applied acaricid had to be repeated seven times before it was successful. Llamas, which are newly introduced in a herd, have to be inspected and treated thoroughly in order to prevent transmission of the infection to other animals.