The South American lungfish Lepidosiren paradoxa inhabits areas with variable pluvial regimes. During aestivation (dormancy state observed in some species during dry seasons), the prolonged period of dryness imposes osmotic stress. We aimed to investigate the physiological and morphological adaptations of RBCs in Lepidosiren paradoxa during aestivation. Here, the lungfish were subjected to aestivation for 20 and 40 days and compared to a control group in an active period. The osmotic fragility, blood osmolality, and pH were measured. Blood smears were performed to assess morphological changes in the RBCs. Lepidosiren paradoxa presented lower hemolysis when compared with a teleost fish and tegu lizard. Hemolysis increased when the lungfish was subjected to 40 days of aestivation (from 6.04 % to 16.51 %; control vs 40-day aestivation). Hematocrit rose in both aestivation groups compared to the control (26.36 %, 41.36 % and 41 %, control, 20 and 40 days, respectively; p < 0.05) indicating changes in RBC volume and hydration status. Moreover, the results revealed increased osmolality in the 40-day aestivation group (244.4 vs 372.1 mmol/Kg; control vs 40-day aestivation). 40 days of aestivation led to a decrease in blood pH when compared to the control and 20-day aestivation groups. Both aestivation durations resulted in a reduction in the perimeter and cell diameters in at least one direction of the RBCs (24 % mean reduction in size from control to 40 days aestivation). These findings suggest that South American lungfish possess remarkable physiological and morphological adaptations in their RBCs during aestivation.