This paper investigates Schistosoma mansoni male-female larval interactions in simultaneous bi-miracidial Biomphalaria glabrata infections. Larval interactions were analysed at four levels of infection: (i), miracidial infectivity, estimated by the prevalence of mollusc infection; (ii), mollusc pathology, measured by the mollusc growth and survival; (iii), dynamics of the cercarial sex ratio; and (iv), cercarial infectivity, measured as the success of development into adulthood. Our results showed that larval interactions exist in S. mansoni-infected B. glabrata. These interactions do not occur in miracidial infectivity, but occur in mollusc pathology, cercarial sex ratio dynamics and cercarial infectivity. Regarding mollusc pathology, we showed that the bi-miracidially-infected molluscs were smaller than the mono-miracidially-infected ones. This could be the result of larval competition. Regarding the dynamics of the cercarial sex ratio, we showed larval female superiority as compared with male larvae inducing the shedding of female-biased cercarial sex ratios. These sex ratios were rhythmic and could be the reflection of an external expression of the intramolluscan development. Regarding cercarial infectivity, we showed that the simultaneous presence of both sexes in a mollusc increased the cercarial infectivity. This result could be due to male-female larval synergism.