The present paper investigates the occurrence, removal, and accumulation of protozoan cysts and helminth eggs in a large anaerobic pond treating municipal wastewater of Ouagadougou (Burkina Faso). With a hydraulic retention time of 6.5 days, the anaerobic pond achieved 100% removal of helminth eggs and protozoan cysts most of the time, except during the hot period. The average residual concentrations of helminth eggs and protozoan cysts in the effluent were respectively 0.45 eggs/L (minimum 0 and maximum 3), and 5.4 cysts/L (minimum 0 and maximum 26). Protozoan cysts accumulation in sludge averaged 1,613 cysts/g total solids. Ancylostoma duodenale, Ascaris lumbricoides and Hymenolepis nana were the main helminth species found in the sludge. After 7 years of operation, the sludge in the pond still contained a high level of viable helminth eggs evaluated at 42%.