The aquatic environment represents the final repository for many human-generated pollutants associated with anthropogenic activities. The quality of natural freshwater systems is easily disrupted by the introduction of pollutants from urban, industrial and agricultural processes. To assess the extent of chemical perturbation and associated environmental degradation, physico-chemical parameters have been monitored in conjunction with biota in numerous biological monitoring protocols. Most studies incorporating organisms into such approaches have focussed on fish and macroinvertebrates. More recently, interest in the ecology of parasites in relation to environmental monitoring has indicated that these organisms are sensitive towards the quality of the macroenvironment. Variable responses towards exposure to pollution have been identified at the population and component community level of a number of parasites. Furthermore, such responses have been found to differ with the type of pollutant and the lifestyle of the parasite. Generally, endoparasite infection levels have been shown to become elevated in relation to poorer water quality conditions, while ectoparasites are more sensitive, and exposure to contaminated environments resulted in a decline in ectoparasite infections. Furthermore, endoparasites have been found to be suitable accumulation indicators for monitoring levels of several trace elements and metals in the environment. The ability of these organisms to accumulate metals has further been observed to be of benefit to the host, resulting in decreased somatic metal levels in infected hosts. These trends have similarly been found for host-parasite models in African freshwater environments, but such analyses are comparatively sparse compared to other countries. Recently, studies on diplozoids from two freshwater systems have indicated that exposure to poorer water quality resulted in decreased infections. In the Vaal River, the poor water quality resulted in the extinction of the parasite from a site below the Vaal River Barrage. Laboratory exposures have further indicated that oncomiracidia of Paradiplozoon ichthyoxanthon are sensitive to exposure to dissolved aluminium. Overall, parasites from African freshwater and marine ecosystems have merit as effect and accumulation indicators; however, more research is required to detail the effects of exposure on sensitive biological processes within these organisms.