The objective of this experiment was to assess the effects of eprinomectin, an extended-release injectable parasiticide, on fescue toxicosis and its impacts on beef heifer performance and reproduction. Fall-born Angus × Simmental heifers (age = 246.3 ± 22.4 d; 264.8 ± 21.1 kg body weight [BW]) were randomly assigned to one of two treatments: extended-release eprinomectin injection (ERE; n = 100) or control (CON; saline; n = 99). Treatments were administered at a rate of 1 mL/50 kg BW. Prior to experiment, heifers were dosed with oral fenbendazole to minimize parasite load. All heifers grazed endophyte-infected tall fescue as a single group and were offered a 50:50 supplement mix of corn gluten feed and soybean hulls (2.7 kg as fed per heifer per day). Body condition scores (BCS), BW, hair coat score (HCS), blood, and fecal samples were collected throughout the experiment. A subset of 40 heifers were randomly selected (20 per treatment) to assess respiration rate (RR). On d 138, heifers began a 14-d controlled internal drug release + prostaglandin synchronization protocol. Following artificial insemination (AI), heifers were exposed to five bulls for 71 d. On d 214 and 291, AI and overall pregnancy rates, respectively, were determined. There was a treatment × time interaction (P < 0.01) for BW, BCS, and average daily gain (ADG). The ERE heifers had greater (P < 0.04) BW and BCS compared to CON heifers from d 55 and 112, respectively. In addition, ERE heifers had greater (P ≤ 0.04) ADG from d 0 to 56, 56 to 112, 112 to 171, and 171 to 214; however CON heifers had greater (P < 0.01) ADG from d 214 to 291. There was no treatment × time interaction or treatment difference (P ≥ 0.27) for HCS, RR, and serum prolactin concentrations. However, serum prolactin decreased (P < 0.01) in all heifers over time. There was a treatment × time interaction (P<0.01) for fecal egg counts (FEC). The FEC did not differ (P ≥ 0.32) on d −1 or 55; however, ERE heifers had decreased (P < 0.01) FEC compared with CON heifers on d 111 (1.52 vs. 13.56 eggs per gram). The ERE heifers tended (P = 0.10) to have greater AI pregnancy rates (69% vs. 58%) and had greater (P = 0.01) overall pregnancy rates (84% vs. 68%) than CON heifers. Spring administration of extended-release eprinomectin improved BW, ADG, BCS, and AI and overall pregnancy rates in fall-born beef heifers. However, the underlying mechanism is still unclear, as there were minimal to no differences in HCS, RR, serum prolactin, and FEC.