We present a new approach to path integral Monte Carlo (PIMC) simulations based on the worm algorithm, originally developed for lattice models and extended here to continuous-space many-body systems. The scheme allows for efficient computation of thermodynamic properties, including winding numbers and off-diagonal correlations, for systems of much greater size than that accessible to conventional PIMC simulations. As an illustrative application of the method, we simulate the superfluid transition of 4He in two dimensions.