The objective of the study was to identify patterns of formation of combined natural foci of clonorchiasis, metagonimiasis and nanophyetiasis in the ecosystem of the Amur River, to analyze their structure, and to determine the risk of infection of the population by the pathogens of these invasions. Materials and methods: Landscape, ecological and malacological methods of studying faunal complexes of floodplain reservoirs were used. The study of fish for contamination with trematode metacercariums was carried out by the compressor method. Results: The studies helped characterize combined natural foci of clonorchiasis, metagonimiasis and nanophyetiasis, which were predetermined subject to the existence of a population of two common hosts in conjunction with the population of the pathogen and the formation of parasitocenosis or parasitocenosis of coinciding parasitic systems of “twin species”. In the floodplain-river ecosystem of the middle and lower reaches of the Amur River there remains the risk of infecting the population with the pathogens of these trematodoses when eating fish of various families caught in the river, its tributaries and floodplain reservoirs. Conclusions: The risk of infestation is attributed to loymopotential of the natural foci of these trematodoses. The areas with the highest risk for the population include the zones of removal of pathogens of clonorchiasis, metagonimiasis, and nanophyetiasis such as riverbeds and fairly large reservoirs permanently associated with rivers.