A comparative study on the extent of urinary tract abnormalities detected by ultrasound was conducted in two villages in an irrigated area of Niger where the pretreatment prevalences were 64.3% and 58.8% respectively. Fewer bladder lesions (20% of abnormalities) and fewer renal lesions (6% of abnormalities) were observed after four consecutive years of follow-up and treatment with praziquantel in the study village as compared to the control village where 54% bladder abnormalities and 36% renal abnormalities were observed. This study suggests that morbidity due to Schistosoma haematobium infection can be reduced by annual treatment over several years in a highly endemic area without other associated interventions.