The authors study the ultrastructural changes within the hepatocyte in the acute (toxemic) form of schistosomiasis. The seven studied patients were all from the same family infected under the same conditions at a creek near Sabara city, state of Minas Gerais, and they did not go under any specific therapy rega rding schistosomiasis. This report confirms our assertive that, there is not a primary and systematical attack directed to hepatocytes and their lesions are subordinated to changes within the stromatic vascular system. The ultrastructural changes found in the seven studied cases were all mild and non-specific and were characterized by citoplasmic organelles changes specially: (dilation of the reticulum's cisterns, effacement of mitochondrias cristae, ribossomes breakage and glicogen deposits). It was also frequently found, enlarged lisossomes, inclusions and residual bodies within the hepatocytes. Those aspects under electronic microscopy reveal the hepatocyte functional behavior during the acute, toxemic form of schistosomiasis and therefore explain the frequent finding of clear cells on optical microscopy.