The purpose of this study was to evaluate the behavior of metals, pathogen parasites, and indicator bacteria in sewage effluents during biological treatment by activated sludge in a wastewater treatment plant in Ribeirão Preto (WTP-RP), Sao Paulo, Brazil. The evaluation was done during a period of 1 year. Results showed that metal concentrations in treated effluents decreased, reaching concentrations according to those established by national regulations. The activated sludge process at the WTP-RP promoted a partial removal of parasites considered as possible indicators according to the WHO guidelines. Reduction factors varied between 18.2% and 100% for agents such as Endolimax nana, Entamoeba coli, Entamoeba hystolitica, Giardia sp., Ancylostoma sp., Ascaris sp., Fasciola hepatica, and Strongyloides stercoralis. A removal was also observed in total and fecal coliforms quantification. The present study represents an initial evaluation of the chemical and microbiological removal capacity of the WTP-RP. The results should be of interest for the authorities responsible for the environmental health at municipal, regional, national, and international levels.