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Paramphistomosis is a neglected parasitic disease of ruminants that contributes to substantial economic losses in livestock production. This study evaluated the haemato-biochemical alterations associated with paramphistomosis in cattle slaughtered at the Jos Abattoir, Plateau State, Nigeria. A total of 40 cattle were examined, comprising 10 non-infected and 30 infected animals. Blood samples, as well as rumen and reticulum tissues, were collected and analysed using standard laboratory techniques. Data were expressed as mean ± standard error of mean (SEM) and analysed using one-way analysis of variance (ANOVA) and Student’s t-test, with significance set at p < 0.05. Out of the 40 cattle examined, 23 (57.50%) were positive for Paramphistomum infection. Infected cattle exhibited a significantly lower packed cell volume (32.96 ± 1.62%) compared to non-infected cattle (37.76 ± 1.24%) (p < 0.05), indicating anaemia. Although total white blood cell counts did not differ significantly between groups (p > 0.05), significant variations were observed in segmented neutrophil and lymphocyte counts (p < 0.05), suggesting an inflammatory response. Thirteen serum biochemical parameters were evaluated. Creatinine, alanine transaminase (ALT), triglycerides, and low-density lipoprotein (LDL) cholesterol were higher in infected cattle than in non-infected cattle; however, these differences were not statistically significant (p > 0.05). Overall, the findings demonstrate that paramphistomosis in cattle is associated with anaemia, inflammatory changes, and mild biochemical alterations indicative of acute infection.