Background: Parasitic infestations are a significant concern in avian species, particularly pigeons, as they serve as hosts for various ectoparasites and endoparasites, impacting their health and productivity. Limited data is available on the prevalence and impact of these parasites in the district of Dera Ismail Khan, Pakistan.Objectives: This study aimed to investigate the prevalence of ectoparasites and helminths in domestic pigeons and assess their effects on hematological parameters.Methods: A total of ۱۵۰ clinically infected pigeons were examined. Ante-mortem examinations involved visual inspection of the head, neck, wings, body surface, feathers, and cloaca for ectoparasites using a magnifying lens. Endoparasites were identified through hemoparasite screening, coproscopy, and post-mortem examination of the gastrointestinal tract. Hematological parameters, including red blood cells (RBCs), hemoglobin (Hb), packed cell volume (PCV), and white blood cells (WBCs), were measured and compared between infected and healthy pigeons.Results: The overall prevalence of ectoparasites was ۹۰%, with Columbicola spp. (۸۰.۶%), Lipeurus spp. (۵۹.۳%), Menopon spp. (۴۲%), and Goniodes spp. (۳۲.۶%) being predominant. Endoparasite prevalence was ۷۵.۳%, including Ascaridia spp. (۴۱.۳%), Raillietina spp. (۳۸.۶%), and Cotugnia spp. (۱۰%). Female pigeons exhibited higher ectoparasite (۸۷.۶%) and endoparasite (۶۰%) prevalence than males. Hematological analysis revealed significantly lower RBC counts, Hb levels, and PCV values (P<۰.۰۵) and higher WBC counts (P<۰.۰۵) in infected pigeons compared to healthy ones. Conclusion: The high prevalence of Columbicola columbae (۸۰.۶%) among ectoparasites and Ascaridia spp. (۴۱.۳%) among helminths indicates a significant parasitic burden in domestic pigeons in Dera Ismail Khan. These infestations were associated with marked hematological changes, including significantly reduced RBC count (۱.۸×۱۰⁶/mL), Hb levels (۷.۵۵ g/dL), and PCV values (۲۱.۰۱%), alongside increased WBC count (۲۴.۰۳/mL). These findings emphasize the urgent need for effective parasitic control strategies to safeguard pigeon health and productivity.