The creation of large freshwater reservoirs is one of the most dramatic anthropogenic impacts on the natural environment. With worldwide rising demand for water, the construction of more reservoirs is inevitable. Although the effects of reservoir construction on many medically important parasites are well known and appreciated, changes to aquatic wildlife host-parasite interactions have been largely undervalued even though a large body of literature exists. The present review examines changes in the wildlife parasite fauna during the impoundment of reservoirs, focusing on the parasites of invertebrates, fish, and birds, the effects both upstream and downstream of the reservoir, parasitic zoonoses, the associated pollution generated, and assesses the impact of the recently completed Three Gorges Dam in China on the Yangtze River's parasite fauna.