To assess the impact level on physical fitness and working capacity in patients with advanced Schistosomiasis japonica, a field study was carried out. According to the records of patients with advanced schistosomiasis in Susong County, Anhui Province, 48 advanced cases without other serious chronic diseases from endemic areas in two townships and 56 healthy individuals from non-endemic area, served as control group with matched ages between 40 and 70 years and matched sex were investigated with questionnaire, anthropometric measure and hemoglobin level. The impairment level of the liver was measured by ultrasonography and physical fitness was measured by the Step test in the case and control groups. All situations including lifestyle, working, socio-economic status and residing environment was similar in the case and control groups. Average height and weight was significantly lower in the case group than in the control group (height = 156.29 and 159.41 cm; weight = 50.72 and 53.92 kg; respectively, all P < 0.05). Thirteen individuals (28.3%) in the case group had moderate reduction of working capacity or even unable to work, but only seven (12.7%) individuals in the control group had moderate reduction of working capacity and all in the control group were able to work (P < 0.01). In the past 1 year, the average working days lost was 4.11 days in the case group and 0.86 day in the control group (P < 0.01). Both groups differed significantly in symptoms of abdominal pain, diarrhea and weakness (all P < 0.05). Twenty-one cases (43.8%) had grade II impairment of the liver and eight cases (16.7%) had grade III impairment of the liver in the case group, whereas seven individuals (12.7%) had grade II impairment of the liver in the control group (P < 0.01), as assessed by ultrasound. The hemoglobin levels and the power of gripping in the case group were significantly lower than those in the control group (Hb = 111.06 and 122.27 g/l; grip = 303.83 and 344.20 N, respectively, all P < 0.01). Physical fitness scores showed the control group (score: 71.84) was significantly fitter than the case group (score: 61.09, P < 0.01). Compared with the control group, the physical fitness of the case group reduced by 15%. The results showed that physical fitness and working capacity were reduced in advanced cases. Although most of the cases were treated and had reached a status of 'clinical cure', the impact on physical fitness and working capacity still existed.