Fish and fish parasites are not well studied as bioindicators for assessing the health of streams and rivers in Ethiopia. Previous studies mainly focused on the diversity, abundance and description of major parasites in fish. Therefore, the present study aimed at evaluating the suitability of fish and fish parasite metrics on the ecological health assessment of streams of upper River Awash. Five sampling sites were selected based on major stressors (like agricultural activities, damming, and water diversion), accessibility for sampling and presence of fish. Environmental variables were collected and analyzed in-situ and ex-situ. Fish were collected from all sampling sites using electrofishing. Around 2242 fish specimens were collected across all sampling sites. 9 fish and fish parasite single metrics were selected and calculated based on the available data. Water Velocity, depth, total phosphorous, and nitrate showed significant variation among sampling sites (P