Hydroelectric dams (HEDs) cause significant socio-environmental damage such as reduced fish diversity, population displacement and health problems. The fishers have extensive local ecological knowledge that can be used to improve understanding of the impacts of HEDs. Therefore, the objective of this study was to verify and evaluate the perceptions of fishers about the impacts caused by the HEDs in the Tocantins River. For this, 25 fishers were interviewed using a questionnaire with 22 questions. Data analyses were performed considering descriptive analysis of the responses. There was convergence in the responses of fishers who perceived the decrease in fish diversity after the construction of the HEDs, including fish of commercial interest, which is linked to a decrease in income and decreased food security for these families. In addition, the fishers noted symptoms that may be a consequence of mercury contamination, and diarrhea as a possible consequence of decreased water quality. Despite all these socio-environmental losses, the fishers report a lack of prior consultation, and low representativeness and transparency in the decision-making process that preceded the construction of HEDs. In general, the fishers perceived themselves as being strongly affected from the socio-environmental point of view and do not cite any benefits offered to the community from these projects.