The present work was designed to study the alleviation influence of fenugreek (Trigonella foenum-graecum) on Nile tilapia (Oreochromis niloticus L.) experimentally exposed to Cd toxicity. A total of 400 fish were randomly divided into 10 groups (G1-G10) and fish was exposed to sub-lethal dose of Cd and fed on fenugreek seeds (crude or extract), individually or in combination for 45 days. The results showed that Cd exposure increased significantly the serum total protein, albumin, globulin, alanine aminotransferase (ALT), glucose and cholesterol, whereas aspartate aminotransferase (AST) and uric acid were significantly decreased. Also, hepatic protein content, catalase (CAT), superoxidase dismutase (SOD) and glutathione-S-transferase (GST) increased significantly due to Cd exposure. Additionally, Cd induced significantly metallothionein-gene (MT) expre-ssion and increased Cd concentrations in different fish tissues. Feeding on fenugreek extract 1% and 3% has reduced some Cd-induced biochemical and antioxidant alterations; however, it decreased ALT, AST and uric acid in serum and also reduced CAT and SOD activities. Fenugreek extract induced MT up-regulation and decreased Cd accumulation in some fish tissues. Although, feeding on fenugreek extract with Cd exposure somewhat reduced the histopathological changes compared to Cd-exposed group, some pathological changes were observed in fenugreek-fed groups especially in high concentrations. It could be concluded that fenugreek seeds extract at level of 1% could be used as feed supplement to Nile tilapia to alleviate some toxic effects of Cd and reduction of Cd accumulation in fish tissues (especially muscle) in such a way to help fish in facing Cd toxicity and reducing the public health hazard.