A pronounced decline in catch of brown trout (Salmo trutta L.) over the last 10-20 years has been reported for many rivers in Switzerland. Impaired health status of the fishes has been suggested as one possible cause of the decline. The present study investigated the health status of juvenile brown trout from four Swiss rivers which experienced reductions of brown trout catches during the last two decades: Emme, Liechtensteiner Binnenkanal (LBK), Necker and Venoge. A gradient approach was applied, studying at each river a headwater (HW), midstream (D1) and downstream site (D2). Fish health was assessed by the following indices: hepatic 7-ethoxyresorufin-O-deethylase (EROD) activity, organ (liver, kidney) histopathology, and gross biometric indices (condition factor, hepatosomatic index). Hepatic EROD activities were generally low without showing significant within- or between-stream differences. Histopathological alterations of the liver displayed a moderate downstream increase in the Emme, LBK and Necker, but not in the Venoge. Between-stream differences of liver pathology were small. Kidney histopathology was not different between upstream and downstream sites, except for Emme and Venoge, where fishes at the downstream sites were infected with the parasite Tetracapsuloidesbryosalmonae, the cause of the proliferative kidney disease (PKD). The findings from this study point to an association of within-stream gradients in water quality, PKD prevalence, fish health and brown trout biomass, whereas between-stream differences of actual fish health status reflecting the different levels of catch declines observed in the four rivers during the last two decades are not evident.