Simple SummaryAluminum-hydroxide is an effective vaccine adjuvant used in most commercial sheep vaccines. It facilitates the establishment of a robust immune response against the vaccine antigen. During the first decade of the 21st century, repetitive injections with vaccines containing aluminum-based adjuvants were proposed to be linked to a progressive wasting syndrome in sheep. The aim of this work was to analyze several clinicopathological parameters, including growth performance, clinical data, and histopathological observations in lambs intensively injected with aluminum-containing vaccines, aluminum-hydroxide only, or a saline solution as control. Although aluminum-hydroxide was linked to chronic inflammatory reactions at the injection site and the development of behavioral changes in sheep, the results presented here indicate that injected aluminum-hydroxide, either alone or in combination with vaccine antigens, is not enough to induce relevant changes in the parameters studied. Other factors such as sex, breed, age, production system, diet or climate conditions could play a role in the development of the previously described wasting syndrome.Aluminum (Al) hydroxide is an effective adjuvant used in sheep vaccines. However, Al-adjuvants have been implicated as potential contributors to a severe wasting syndrome in sheep—the so-called ovine autoimmune-inflammatory syndrome induced by adjuvants (ASIA syndrome). This work aimed to characterize the effects of the repetitive injection of Al-hydroxide containing products in lambs. Four flocks (Flocks 1–4; n = 21 each) kept under different conditions were studied. Three groups of seven lambs (Vaccine, Adjuvant-only, and Control) were established in each flock. Mild differences in average daily gain and fattening index were observed, indicating a reduced growth performance in Vaccine groups, likely related to short-term episodes of pyrexia and decreased daily intake. Clinical and hematological parameters remained within normal limits. Histology showed no significant differences between groups, although there was a tendency to present a higher frequency of hyperchromatic, shrunken neurons in the lumbar spinal cord in the Adjuvant-only group. Although Al-hydroxide was linked to granulomas at the injection site and behavioral changes in sheep, the results of the present experimental work indicate that injected Al-hydroxide is not enough to fully reproduce the wasting presentation of the ASIA syndrome. Other factors such as sex, breed, age, production system, diet or climate conditions could play a role.