Crayfish plague, caused by the oomycete Aphanomyces astaci, is a serious disease of European freshwater crayfish and has eliminated entire populations in several European countries. In September 2011, mortality was observed among the Austropotamobius pallipes population of a river basin in the Abruzzi region (central Italy), and A. astaci DNA was detected by PCR in dead crayfish. A systematic survey was carried out to evaluate the spread and the effects of the plague in the river basin. The source of the outbreak remained unknown since North American crayfish species, which frequently act as subclinical carriers of the infection, were not detected in the area. The A. pallipes population disappeared from a river stretch of ~1 km, where A. astaci infection was detected in dead crayfish. However, apparently unaffected crayfish were still present upstream of that area as well as in a tributary that joined the brook in the apparently depopulated stretch. A. astaci infection was not detected in dead individuals collected in the upstream area and tributary. A follow-up visit conducted in the following season showed the presence of A. pallipes in the river stretch hit by the plague. In this outbreak, the spread of the infection could have been limited by a low density of the crayfish population and by the geographic conformation of the river basin, which includes a dense network of small tributaries, characterized by high flow velocity and low water temperature. In this particular setting, crayfish plague outbreaks can remain undetected. This underlines the importance of active monitoring programs aimed at the prompt recognition of both episodes of mortality and the presence of non-indigenous crayfish species.