Acanthogyrus (Acanthosentis) tilapiae parasites were collected from the intestines of 300 fish belonging to three tilapia species sourced at the River Nile, Giza, Egypt. The proboscis of the parasite was characterized by three rows of hooks that curved towards the posterior of the body. The first row is supported by unmodified hooks. The parasite tegument has a series of alternative folds and a large number of pores. Sensory ganglia are located on the surface of the proboscis and body. Acanthogyrus (Acanthosentis) tilapiae provokes an aggressive host response indicated by hyperplasia of the intestinal goblet cells and focal eosinophil infiltrations. This acanthocephalan parasite shows a highly modified adaptation to its site of host infection.