The study of digeneans and their association with mollusks commenced in Europe and South America during the mid-19th to early 20th centuries. Digenean infestation can severely degrade host tissue, leading to diminished energy resources and eventual host mortality. However, these parasites can also induce various non-lethal effects, including changes in growth rates, survival rates, and reproductive capabilities, alongside physiological and behavioral alterations. While numerous studies have explored the ecological effects of digeneans on hosts in Europe and North America, our understanding of these dynamics in South America, particularly in first intermediate hosts, remains limited. Therefore, this paper aims to provide an overview of ecological investigations into digenean-mollusk systems in South America, emphasizing the importance of robust sampling designs and statistical analyses to address key ecological inquiries. Although fascinating examples exist of parasitism influencing different hierarchical levels of digenean-mollusk systems, particularly at the individual, population, and community levels, documentation of their ecosystem-level impacts is comparatively sparse. As South American studies of digenean-mollusk systems from an ecological perspective are still in their early stages, there is immense potential for uncovering unique ecological patterns in this largely unexplored region, propelling us toward further developmental strides in the parasite ecology.