Nosemosis caused by the microsporidia Nosema apis and Nosema ceranae are among the most common pathologies affecting adult honey bees. N. apis infection has been associated with a reduced lifespan of infected bees and increased winter mortality, and its negative impact on colony strength and productivity has been described in several studies. By contrast, when the effects of nosemosis type C, caused by N. ceranae infection, have been analysed at the colony level, these studies have largely focused on collapse as a response to infection without addressing the potential sub-clinical effects on colony strength and productivity. Given the spread and prevalence of N. ceranae worldwide, we set out here to characterize the sub-clinical and clinical signs of N. ceranae infection on colony strength and productivity. We evaluated the evolution of 50 honey bee colonies naturally infected by Nosema (mainly N. ceranae) over a one year period. Under our experimental conditions, N. ceranae infection was highly pathogenic for honey bee colonies, producing significant reductions in colony size, brood rearing and honey production. These deleterious effects at the colony level may affect beekeeping profitability and have serious consequences on pollination. Further research is necessary to identify possible treatments or beekeeping techniques that will limit the rapid spread of this dangerous emerging disease.