The distribution of Schistosoma haematobium in the Sichili Health Zone in the Western Province of Zambia was studied by performing cross-sectional surveys in Mwanalulenga (n = 493), a cluster of rural settlements along the Namakala stream and the Machili river, Mulobezi (n = 114), a semi-urban settlement along the Mulobezi river; and school-based surveys in Mulauli (n = 85), a small rural settlement along the Machili river, and in Sichili (n = 199), along the Namakala stream. The S. haematobium infection was assessed by the urine filtration technique. Prevalences ranged from 20.6 to 87.1%, 23.8% of all people were heavily infected (greater than or equal to 50 eggs per 10 ml of urine).