Helminth eggs and protozoan cysts were enumerated in raw and treated wastewater in Tunisia in order to determine their removal by wastewater treatment and to provide quantitative data for developing regulations for wastewater quality that are currently lacking. Raw and treated wastewater samples were collected from 17 plants in Tunisia during 2006-2007 and analyzed for parasites using the modified Bailenger method. Two groups of parasites, namely, Ascaris sp., Entamoeba coli, Enterobius vermicularis, and Taenia sp. (group 1) and Entamoeba histolytica/dispar, Giardia sp., and Taenia sp. (group 2) could statistically be distinguished according to their removal by wastewater treatment. Group 1 parasites were removed by 1.1 log(10) (92.4%) and group 2 parasites by 0.61 log(10) (76%). The ubiquitous presence of parasitic protozoa in Tunisian wastewater and ineffective wastewater treatment lead to their proliferation in surface waters with a high probability of exposure of human and animals to these parasites and consequent adverse health effects, as is apparent from epidemiologic data as well. This study provides a quantitative basis for risk assessment studies and development of mitigation strategies, such as improving wastewater treatment efficiency.