Infection levels with the parasitic nematode Contracaecum osculatum in Eastern Baltic cod have increased in the last decades. Eastern Baltic cod is transport host for this parasite that has a high affinity for the liver of the fish. The liver is a highly vital organ and damage to the liver tissue can result in reduced functionality of the organ. Previous studies have revealed that cod with high infections loads reveal impaired physiological performance, reduced nutritional condition and show signs of having a liver disease. Yet, little is known about the pathological changes and inflammatory reactions of the cod liver related to the infections. In this study, we performed histological examinations on 30 Baltic cod livers caught in the eastern part of the Baltic Sea (length; 38 ± 0.9 cm, weight; 454 ± 34.8 gram) and three Sound cod livers (length; 63 ± 2.9 cm, weight; 3396 ± 300.2 gram) to categorize the degree of inflammation and its relation to pathological changes in infected cod livers. We further investigated how C. osculatum infection levels varied with intensity of inflammation and co‐infections. We found that high infection loads with C. osculatum caused severe inflammation in the liver tissue of cod and reduced fat content of the hepatocytes. Conspicuous amounts of glycogen were found in the muscle and intestinal epithelial cells of the nematodes and parasitic co‐infections occurred more frequently in the most heavily infected livers.