We conducted a cross-sectional survey on the impact of ivermectin after repeated treatment in five communities in Imo State, Nigeria. Rapid epidemiological mapping of onchocerciasis (REMO) carried out in 450 subjects in 1994 prior to the launching of mass drug administration were compared with re-examinations of 540 subjects in 2023. We found palpable nodule reduction from 47.2% to 12.2% and popular dermatitis decreased from 42.9% to 5.9%. Reductions in other clinical features were observed. Overall, a significantly higher proportion of males were infected than females (P<0.05). The implications of these results were discussed in line with the reported benefits of ivermectin therapy.