The accelerated growth of finfish aquaculture has resulted in a series of health problems, including blood disorders by hemoparasites; there are scarce studies about these agents and their impact in actual intensive farming. The aim of this study was to identify and quantify the hemoparasites present in monocytes and erythrocytes in the blood of tilapia and their correlation with the hematological profile. Blood samples were collected from caudal vessels of 15 cage-reared Nile tilapia (Oreochromis niloticus), with 70 ± 10 g weight on average, from Itambaracá Municipality, Parana State, Brazil. The total red blood cells, mean corpuscular volume, hematocrit, total and differential white blood cells counts, and the number of thrombocytes were determined in blood smears stained with May-Grünwald-Giemsa-Wright and Quick Panoptic. The results showed the presence of pleomorphic cytoplasmic inclusions with corrugated appearance and basophilic staining, mainly in monocytes, suggesting Anaplasmataceae parasitemia and inclusions with the same morphological characteristics in erythrocytes of one Nile tilapia. The hematological analysis showed no significant difference (P < 0.05) between infected and not infected fish, and therefore, there was no correlation between parasitemia and hematological profile. These observations allow us to infer that the intracytoplasmic inclusions in monocytes and erythrocytes are compatible with the family Anaplasmataceae. There was no correlation between the blood profile and low level of parasitemia.