To evaluate the potential impact of an urban wastewater-treatment plant on Ria Formosa coastal lagoon, a sentinel species, the clam Ruditapes decussatus, was exposed along a gradient of the effluent's dispersal for 1 mo. Three exposure sites were selected to study the responses of 3 biomarkers: electron transport system, acetylcholinesterase, and lipid peroxidation. As complementary data, morphometric measurements, condition index, and lipid and protein content were considered together with in situ physicochemical characterization of the sites (temperature, salinity, pH, and dissolved oxygen). Electron transport system activity levels were between 35.7 and 50.5 nmol O 2 /min g protein, acetylcholinesterase activity levels ranged from 2.6 to 3.8 nmol/min g protein, and lipid peroxidation ranged from 174.7 to 246.4 nmol malondialdehyde/g protein. The exposure sites shaped the response not only of biomarkers but also of "health" parameters (protein, lipids, and condition index). Lipid peroxidation was the most responsive biomarker also associated with electron transport system, especially at the closest site to the urban wastewater-treatment plant. Because of the presence of complex mixtures of contaminants in urban effluents, biomarker responses can provide valuable information in environmental assessment. However, it is vital to identify all biological and ecological factors induced by the natural life cycle of clams. Abiotic factors can mask or overlap the response of biomarkers and should be considered in a multibiomarker approach.