Schistosomiasis remains an important health problem in many tropical countries and is being seen with increasing frequency in immigrant populations and tourists in developed countries. The pattern of organ involvement and clinical presentation of schistosomiasis in 80 patients (male: female, 9:1) during a five-year period (2001-2005) was examined from archival histopathology records. The urinary bladder was the most common organ affected [50 (62.5%)]. Gastrointestinal, male and female genital schistosomiasis were detected in 12 (15%), eight (10%) and five (6.1%) cases, respectively. Hematuria was the most common presenting symptom [34 (42.5%)], and bladder cancer was the only malignancy found to be associated with the infection. A high clinical index of suspicion usually allows for a preoperative diagnosis where indicated and avoidance of radical surgery. While research for the development of an effective vaccine continues, a plea is made for the expansion of multinational control programs in sub-Saharan Africa.