The aim of this study was to perform a microbiological risk assessment of fish infected with Opisthorchis felineus in the Birtaban-Shalkar lake system in Akmola Region in Kazakhstan and to determine the resistance of O. felineus metacercariae colonizing fish muscles to various meat processing methods. The prevalence and severity of O. felineus infection was evaluated in three economically important fish species: Abramis brama (Linneus, 1758), Carassius auratus (Linneus, 1758), and Leuciscus idus (Linneus 1758). The microbiological quality of fish meat was evaluated using conventional methods based on the results of sensory analysis (n=34), analysis of proximate chemical composition, counts of mesophilic aerobic and facultative anaerobic microorganisms (CMAFAnM), coliforms, Salmonella spp., Listeria monocytogenes, and heavy metal concentrations (Pb, Hg, Cd, Cu, Fe, Zn, Mn, Ni, and Co) in the meat of infected and non-infected fish. Metacercariae were resistant to various meat processing methods. Opisthorchis felineus metacercariae were identified in all analyzed fish species. The meat of infected and control fish differed in proximate chemical composition. The content of heavy metals did not exceed maximum permissible limits. In comparison with non-infected fish, the meat of infected fish was characterized by a higher content of Fe (by 1.7%) and Zn (by 12.9%) and a lower content of Ni (by 5.5%), Cu (12.5%), Co (by 43.8%), Mn (by 59%), and Pb (by 37.3%). The content of Ca and Hg in fish meat was similar in both groups. Freezing, thermal processing, and salting destroyed 100% of O. felineus metacercariae in fish. Drying without pre-freezing was the only processing method that did not eliminate liver fluke larvae from fish meat.