The aim of this study was to investigate the apoptosis-related gene expression in hamster opisthorchiasis after praziquantel treatment. Hamsters were infected with Opisthorchis viverrini metacercariae then treated with praziquantel. The expression of apoptosis-related genes [i.e., apoptosis gene Bcl-2-associated protein X (BAX), caspase 9, p53, and protein kinase B (PKB)] was detected by real-time reverse transcription polymerase chain reaction. Histopathological analyses of liver tissues were studies by staining the sections with hematoxylin and eosin using light microscopy. Apoptotic assay was used to localize the apoptotic cell death. The results show that BAX, Akt/PKB, p53, and caspase 9 expression level were significantly increased on day 30 post infection and at 6 h post treatment and gradually decreased nearly to the uninfected control and 24 h post treatment, perhaps due to a decrease in inflammatory cells. Apoptotic staining was positive reaction at inflammatory cells and nuclei of epithelial bile ducts. Although using praziquantel has an advantage in killing parasites, our results show the effect of praziquantel treatment from host immune response that induces increased apoptosis-related genes in the short term due to an increase in inflammatory cells surrounding the bile ducts.