Recently, an increasing disparity has emerged in the need for raw fish meal (FM) and its supply, along with the environmental and financial obstacles associated with its use. Therefore, increasing and elevating the diversity of alternative protein sources for aquaculture nutrition is imperative. The study investigated the impact of substituting FM protein with EW meal on the growth, haemato-biochemical response and intestinal histomorphology of Nile tilapia. Up to 20% fishmeal replacement with EW meal had no adverse effects on fish growth performance. A quadratic analysis of the final body weight and EW meal level indicated the best growth performance at 17.5% replacement. Fish fed the 40% replacement level had significantly decreased height and width of intestinal folds and number of mucosal goblet cells compared to the control. Although red and white blood cell counts were found unchanged between the control, the 10% and 20% replacement groups, a significantly higher number of white blood cells and a lower number of red blood cells were found in the 40% group compared to the control. Blood glucose level was the highest, while haemoglobin level was the lowest in the 40% group. In the same group, significantly higher frequencies of erythrocyte cellular and nuclear abnormalities were noted. Lipid droplet accumulation in the liver was significantly higher in the 40% group, whilst the 10% and 20% groups showed no significant difference compared to the control.