Fishmeal (FM) is the main protein source in fish feed. However, it is quite expensive due to its limited resources. Therefore, finding a dietary alternative to the FM to sustain fish production is crucial, and the current study was performed to assess the impact of poultry offal silage (POS) with or without betaine supplementation; as an effective and cheaper alternative to FM; on feed efficiency, growth performance, spleen morphology and intestinal morphometry of Nile tilapia (Oreochromis niloticus) fingerlings. Four dietary treatments were formulated: (1) FM based diet, (2) FM‐B; FM diet +0.7% betaine, (3) POS diet and (4) POS‐B; POS diet +0.7% betaine. Each dietary treatment consisted of three replicates (n = 10/replicate), and the experiment was continued for 16 weeks. By the end of the experiment, spleen and intestine specimens were collected from 15 fish (n = 5/replicate) for histopathological assessment. The results were statistically analysed using GLM procedures of SAS 9.4. Feed efficiency increased in both POS‐B and FM‐B groups (p = 0.01), while body weight and body weight gain showed only weak tendencies towards an increase (p = 0.10 and 0.12, respectively). The villi length was the highest in POS‐B fed group (p < 0.01). In addition, melanomacrophage centres of the spleen increased in both betaine‐supplemented groups (p < 0.01). From our findings, we conclude that betaine supplementation with poultry offal silage improved production performance and immune status of Nile tilapia fish.