The macro-pathological impact of plerocercoid infection of perch Perca fluviatilis livers was quantitatively determined by an index of liver lesion (ILL) in fish from Upper Lake Constance (ULC). These results were compared to the ILL values of perch from two other lakes. From February to November 1999, 2071 perch were examined from the three sites. Prevalence of infection in ULC was 13% in actively growing first year (0+ year) perch and 94% in older fish, whereas in the two lakes used for comparison the figures for 0+ year perch were 12 and 20%, and in older fish 62 and 60%, respectively. Infected livers from perch caught in ULC revealed significantly higher ILL values than those of fish from the other two lakes. Perch livers from ULC containing more than three Triaenophorus nodulosus larvae also showed significantly more serious pathological alterations than uninfected livers or those with normal infection levels of one to three T. nodulosus. In all three lakes, excluding heavily infected perch from ULC, 0+ year perch livers revealed little or no damage, whereas in livers of older perch pathological alterations were apparent. In addition, analysis of age and total length data showed that perch infected with one to three parasites in ULC grew significantly slower than uninfected ones, and severely infected perch (greater than three parasites) grew significantly slower than those with a normal parasite load. With respect to mass, growth of ULC fish suffering normal infection (49% of all adults) was reduced by 9% and in those with severe infections (45% of all adults) growth was 16% below expected at normal harvesting age.