It was reported that Nesha village had the highest prevalence of Heterophyes heterophyes in Dakahlia Governorate. Another village of complete absence of Heterophyiasis was selected [El-Gawaber village]. Stool analysis by kato technique was done for a representative sample of both villages to determine the magnitude of the problem of heterophyiasis in both villages. Heterophyiasis was more prevalent in Nesha [31.4%] than El-Gawaber village [0.3%] A case control study was done to determine the risk factors of heterophyiasis together with tracing of the source of infection. The most prevalent clinical symptoms that mimic amaebiasis were flatulence [64.8%], vague abdominal pain [47.7%] and diarrhea [6.7%] while the symptoms that mimic peptic ulceration were heart burn [27.3%), epigastric pain [25.9%] and nausea [25.3%] with a statistical significant difference between cases and controls. Family history of heart failure and cerebral lesions were significantly more common in Nesha than in El-Gawaber. There was no statistical significant difference between Nesha cases and El-Gawaber controls as regards the habit of consumption of roasted fish. On the contrary, there was an obvious and statistical significant difference between cases and controls as regards the habit of consumption of salted fish [type of Fesiekh, salting, source, frequency of consumption and the frequent consumption in different occasions] . No Perinella conica snails were present in water channels of both villages. The prevalence of encysted metacercariae of Heterophyes heterophyes in the samples of Fesiekh obtained from Nabrouh, whether Mugil cephalus , Mugil auratus and Mugil capito was 83%, 78% and 8% respectively with a high intensity of infection [119+28.7, 98±7.1 and 13±2.3 encysted metacercaria/gram] respectively. There was no standard safe method for manufacturing of salted fish in Nabarouh. Further studies are recommended to evaluate the complications of heterophyiasis and its possible relation to cardiac failure and cerebral lesions in Egypt. Food safety measures about Fesiekh manufacture is also recommended.