Perkinsosis is one of the most widespread diseases affecting commercially important species of molluscs globally. We examined the impact of Perkinsus spp. on shell growth at the individual scale in 2 clam species: Ruditapes decussatus from Mundaka Estuary (Spain) and R. philippinarum from Arcachon Bay (France). At Arcachon, 2 contrasting sites in terms of environment and Perkinsus olseni presence were chosen: Arguin (disease-free) and Ile aux Oiseaux (infected site). We monitored the dynamics of perkinsosis over the course of the experiment at Mundaka and Ile aux Oiseaux. Prevalences were high (>70%), and intensities were around 105 cells g-1 wet gills at Ile aux Oiseaux, and 106 cells g-1 at Mundaka. No significant differences in prevalence or intensity were observed over time. A 2 yr field growth experiment of tagged-recaptured clams was performed to determine individual clam growth rate, condition index (CI), and Perkinsus spp. infection intensity. Clams were collected at Ile aux Oiseaux and transplanted to Arguin. The growth rate was always significantly and negatively correlated with Perkinsus spp. infection, and positively correlated with CI. CI and Perkinsus spp. infection explained 19% and 7% of the variability of the growth rate at Mundaka and Ile aux Oiseaux, respectively. In experimental clams at Arguin, P. olseni infection explained 26% of the variability of the growth rate at the lower tidal level. Our results suggest that at a concentration of between 105 and 106 cells g-1, perkinsosis affects the physiological functions of the clams, highlighted by its impact on the growth rate.