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Recent reports of <i>Eucoleus garfiai</i> in wild boars in southern Italy have highlighted the need for collecting epidemiological data on the presence of this parasite and understanding the role of possible interactions between wild boars, <i>E. garfiai</i>, and the environment. This study analyses, using histopathological and biomolecular techniques, the presence of <i>E. garfiai</i> in tongue samples of wild boars hunted in four provinces of the Campania and Latium regions (Italy), in areas located above and below 900 m above sea level (asl). Histopathological examinations revealed the presence of adults and eggs of nematodes, which were subsequently identified as <i>E. garfiai</i> by biomolecular analysis, in the tongue epithelium. The detection of the parasite was more frequent in samples collected from hunting areas located above 900 m asl than in those collected from areas located below 900 m asl (66.67% vs. 38.09%; <i>p</i> < 0.01). Some species of earthworms are intermediate hosts of <i>E. garfiai</i> and it is well known that earthworms are more present in high quality soils. Therefore, we can suggest that the higher prevalence of <i>E. garfiai</i> at higher altitudes is probably linked to a greater presence of earthworms in the soil, due to its higher quality in these areas.