Anisakiasis is a parasitic disease caused by the consumption of raw or undercooked fish containing the third larval stage of anisakid nematodes. Safety in fish consumption from extractive fisheries is a challenge for public health authorities. This study presents the hematological analysis, necroscopic and histopathological examination of three Hoplias lacerdae parasitized by Anisakis spp. captured in an affluent of the Teles Pires River, in the municipality of Sinop, State of Mato Grosso, Brazil. At necropsy, intense parasitism was observed, characterized by free and adherent anisakid larvae in organs and mesentery. In the histopathological study, there were nephrotic alterations and hepatopathies, as well as the first report of the presence of Anisakis cyst adhered in the myocardium of Hoplias lacerdae. There was a correlation between the increase in the number of parasites and the circulating leukocytes, influenced by the number of neutrophils and eosinophils. However, other studies should be designed to elucidate the pathophysiological and epidemiological changes in Hoplias lacerdae by the parasitism of Anisakis spp., due to its socioeconomic importance, as well as the potential risk to public health.