Verona integron-encoded metallo-β-lactamase–producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA) and other carbapenemase-producing organisms represent an emerging U.S. public health threat because of high levels of antibiotic resistance and the potential for rapid spread in health care facilities (1,2). During September 18–November 19, 2018, CDC received 31 reports of VIM-CRPA through the Antibiotic Resistance Laboratory Network. Six cases (19%) occurred in U.S. patients who had recently undergone invasive medical procedures in Mexico. To identify additional cases (defined as isolation of VIM-CRPA from a patient who had an invasive procedure in Mexico in the month preceding specimen collection), CDC and state partners posted an Epi-X alert on November 19, 2018, and issued notifications through the Emerging Infections Network and to medical professional societies. As of January 18, 2019, a total of 12 cases had been identified in seven states, including four in Utah, three in Washington, and one each in Arizona, Arkansas, Oregon, Texas, and West Virginia; specimen collection months ranged from November 2015 through December 2018 (Figure).