In the aquatic environment, fish are subject to different pollutants and environmental variations that favour stress on animals, making them vulnerable to pathogens. Fish parasites are excellent biological indicators of environmental quality, as their parasitic population may increase or decrease in response to changes in water parameters and/or the presence of pollutants. Ectoparasites are considered excellent indicators of environmental quality because they have a monoxenic life cycle with high reproductive rates that have been responsible for the immediate response to changes in aquatic biota. In turn, parasites with a heteroxenous life cycle are also responsive to environmental variation because, with the mortality of intermediate hosts, their population can be easily changed. However, studies with endoparasites and their relation with the environment are more numerous, as they are accumulators of pollutants, especially trace elements, either via fish or through stages of development outside the host that also contribute to the accumulation of metals. Moreover, Digenea, Acanthocephala, Nematoda and Cestoda parasites can compete for trace elements that are bioavailable in the environment, as fish with a greater abundance of parasites have a lower concentration of toxic metals in their tissues. Furthermore, they have a high affinity for trace elements that are toxic to human and fish health (arsenic, mercury, lead and cadmium). This review is a comprehensive overview of the use of fish parasites as environmental sentinels and describes their potential as bioindicators of effect and accumulation, and evaluates their application in fish farms environments.