The aim of present study was determination effects of dietary administration of C. militaris spent mushroom substrate (SMS) on mucosal and serum immune parameters, disease resistance, and growth performance of Nile tilapia (Oreochromis niloticus). Two hundred twenty five fish of similar weight (37.28 ± 0.10 g) were assigned to the following diets [0 (T1- Control), 5 (T2), 10 (T3), 20 (T4) and 40 g kg−1 (T5) SMS]. After 60 days of feeding trial, growth performance, skin mucus lysozyme and peroxidase activities as well as serum innate immune were measured. In addition, survival rate and innate immune responses were calculated after challenge test (15 days) against Streptococcus agalactiae. The results revealed that regardless of inclusion levels, feeding Nile tilapia with SMS supplemented diets significantly increased skin mucus lysozyme and peroxidase activities as well as serum immune parameters (SL, ACH50, PI, RB, and RB) compared control group (P < 0.05). The highest increment of immune parameters was observed in fish fed 10 g kg−1 SMS which was significantly higher than other treatments (P < 0.05). Also, the relative percent survival (RSP) in T2, T3, T4, and T5 was 61.11%, 88.89%, 66.67, and 55.56%, respectively. Among the supplemented groups, fish fed 10 g kg−1 SMS showed significant higher RPS and resistance to S. agalactiae than other groups (P < 0.05). Regarding the growth performance, SGR, WG, FW, and FCR were remarkably improved (P < 0.05) in SMS groups; the highest improvement observed in 10 g kg−1 SMS treatment. According to these finding, administration of 10 g kg−1 SMS is suggested in tilapia to improve growth performance and health status.