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We investigated the biochemical and ultrastructural changes in the liver of the freshwater fish, European perch (Perca fluviatilis), in response to Aphanizomenon flos-aquae bloom in the Gruža Reservoir, Serbia. The activities of total manganese- and copper zinc-containing superoxide dismutase (Tot SOD, Mn-SOD, Cu/Zn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR) and biotransformation phase II enzyme glutathione-S-transferase (GST), as well as concentrations of total glutathione (GSH) and sulfhydryl (-SH) groups were examined before and during the bloom period. Mn-SOD activity was significantly higher, while the activities of Cu/Zn-SOD, CAT and GSH-Px and the concentration of the -SH groups were significantly lower during the bloom. The ultrastructure of the liver revealed necrotic and apoptotic damage to the hepatocytes during the bloom period. Our work represents the first study to report the influences of an Aphanizomenon flos-aquae bloom in the Gruža Reservoir on antioxidant biomarkers and on histopathological alterations in the liver of the freshwater fish European perch (Perca fluviatilis).