Abstract Sublethal effects of trimethoprim (TMP) were evaluated in four freshwater organisms: Pseudokirchneriella subcapitata and Lemna minor (growth inhibition), Daphnia magna (reproduction and growth inhibition) and Poecilia reticulata (swimming activity inhibition). Cytochrome P4501A induction was also evaluated in P. reticulata. TMP showed varying levels of toxicity in the four test performed, with NOEC for the various endpoints in the range of 3.12–25mgL−1. The compound was active on P. reticulata at concentration ≥50mgL−1 causing inhibition of swimming activity. In the same organism an induction of CYP1A protein, mainly in kidney, gills and intestine, was also detected. L. minor was more sensitive than unicellular algae to TMP, with a NOEC of 12.5mgL−1. The lowest NOEC (3.12mgL−1) was obtained in D. magna reproduction test and then a Risk Quotient of <0.03 was calculated by comparing the PNEC (31.2μgL) and the TMP concentrations usually detected in freshwater (<1μgL−1). However, based on recently reported data, it was concluded that while TMP concentrations normally detected in surface water are below those able to evoke appreciable biological effects in the various aquatic organisms, TMP concentrations in aquaculture and hospital effluents can be one to three orders of magnitude higher. Furthermore, the co-occurrence and additive effects of other antifolic agents should be taken into account for a cautious risk assessment of the drug.