Objective To understand the impact of construction of the Three Gorges Project on the paragonimiasis in Xingshan county. Methods Four epidemiological surveys including sero-epidemiologic investigation and the metacercaria of Paragonimus from crabs captured were carried out in 2012-2016. The data of the paragonimiasis before the construction and the beginning of the construction and the water storage period were collected. Results The active surveillance was conducted on 1 128 residents and the total positive rate of serology test was 2.57%(29/1 128), while the Nanyang town had the highest rate of 8.12%(25/308)with statistical significance(χ²=64.313, P=0.000). All of the three hundred and forty fresh-water crabs were captured and the positive rate was 27.94%(95/340), while the Gufu town had the highest rate of 48.80%(61/125)with statistical significance(χ²=22.942, P=0.000). The infection rates of the crabs before and after the construction were higher than the beginning of the construction period. This account had statistical significance(χ²=11.348, P=0.003). The positive rate of the serology tests cannot be compared because of the different detection technology. Conclusion The infection rate of the crabs was still high, and new area of high infection rate appeared in Xingshan because of the Three Gorges Project. Measures on continuous surveillance and health education should be taken to avoid the occurrence of outbreak.