The goal of this study was to evaluate the adverse effects of wastewater effluents on freshwater crucian carp, Carassius auratus, inhabiting Sincheon stream using the integrated biomarker response (IBR) at the genotoxic (micronucleus [MN] test), oxidative stress (activity of catalase [CAT] and glutathione S-transferase [GST], and level of lipid peroxidation [LPO]), histopathological (degree of tissue changes [DTC]), and physiological (condition factor [CF] and liver somatic index [LSI]) levels. The CF and LSI were significantly (p<0.05) enhanced in fish from downstream sites (DS1 and DS2) as compared to that of upstream (US) fish samples. Moreover, a significant increase in morphometric indices (DTC) was observed in C.auratus collected from downstream sites (p<0.05) and histopathological responses showed the degree of pathogenicity in the order of liver>kidney>gills. The activities of CAT, GST, and LPO in fish from the DS1 and DS2 sites were notably increased in gills, liver, and kidney compared to that of fish from the US site. Additionally, the MN test level in C.auratus from the DS1 and DS2 were significantly increased (p<0.05) when compared with that of the US site. Considering the higher bioaccumulation of Cd, Co, Cr, Mn, Ni, and Pb in gills, liver, and kidney of C.auratus collected from downstream sites compared to that of the upstream site (p<0.05), the observed toxicity was likely attributable to metal accumulation. The multi-level IBR index was higher at the DS1 site (15.08) than at the DS2 (1.02) and the reference US (0.00) sites. Therefore, these findings demonstrated that wastewater effluent discharge induces significant DNA damage, oxidative stress, and tissue injuries in C.auratus and suggested that the multi-level IBR approach should be used to quantify these effects on fish in streams and rivers.