Egypt is the topmost aquaculture producer in Africa and the third largest tilapia producer globally. Nile tilapia in particular is the cornerstone of fish farming in Egypt. Recently, fish farms have experienced unusual tilapia mortality during summer season, threatening further growth of the sector. In the present study, we conducted a tilapia epidemiology and health economics survey in five Egyptian aquaculture governorates for the mapping of major risk factors and economic impacts associated with tilapia mortality during summer 2018.