Introduction: The River Tambo basin is one of the main hydrographic systems of the Peruvian western watershed, being a source of development for agriculture, agroindustry, livestock, and domestic use in the Tambo Valley and Arequipa City. Objective: To analyze the structure of macroinvertebrates in River Tambo, Perú and assess the water quality through this community. Methods: Five sampling events were conducted between December 2018 and November 2019 in 12 stations, using a Surber net (500 μm). Macroinvertebrates were identified at a family level. To assess community structure, richness, Simpson’s dominance index (D), Pielou’s evenness (J’), and true diversity of order 1 were determined. A nMDS based on the Bray-Curtis index was used to evaluate dissimilarity. To check for differences in community structure, ANOSIM and two-way MANOVA were used. SIMPER was used to establish family contribution to sample similarity. Relations between physicochemical and biological variables were determined by CCA. ABI index was applied to assess ecological quality. Results: 32 families were recognized, being the most abundant: Baetidae, Chironomidae, Leptohyphidae, Simuliidae, Hydroptilidae, and Elmidae. The middle and low zones of the basin showed the highest and lowest diversity respectively. There were significant differences (P < 0.05) in the community structure indices among the 12 stations differed. There was a higher similarity among the 12 stations in December. ABI scores increased from the low to the middle part of the river, which showed the highest ecological quality. Conclusion: Macroinvertebrate communities from River Tambo reflect ecosystem conditions. Environments impacted by human activities show lower diversity and ecological quality, due to the structure, habitat, and water quality of the river being altered.