In Ukraine is the second largest (after the Ob-Irtysh in Russia) endemic area of opisthorchiasis in the Dniepr basin, which requires environmental monitoring and prevention, despite the decline in the number of reported new cases. We have analyzed incidence on opisthorchiasis in Poltava region. Identified main parameters of the epidemic process. The highest rates in recent years consistently recorded in the basin of the river Sula (Lokhvitskii, Lubensky, Orzhitsky areas) and river Khorol (Mirgorod, Semenovsky areas). Among the preventive measures it is important to improve the quality of wastewater treatment, reliability and efficiency of drainage systems, improvement of rivers and continuous study of populations of Bithyniidae snails resistance to environmental factors.