Laparoscopy is a reliable, minimally-invasive technique to obtain reproductive information from wild and captive sturgeon. While generally considered safe, the physiological consequences of laparoscopy in sturgeon are unknown. Therefore clinical pathology changes in juvenile, Atlantic sturgeon (Acipenser oxyrinchus oxyrinchus) following experimental laparoscopy at 10 and 22°C were described. Control fish were anesthetized with MS-222 according to the same protocols as surgical fish, but were not incised. Surgical procedures did not affect heart and ventilation rates, signs of stress (skin redness) or time to recover from anesthesia in comparison to control fish. Anesthesia with MS-222 produced a transient (by 1 h) hemo-concentration (elevated protein and electrolytes), erythrocyte swelling (increased PCV and MCV) and stress response (elevated cortisol and glucose); and a delayed (by 24 h) increase in RBC, leukopenia and increased N : L ratio. Surgical procedures resulted in a delayed (by 24 h) decrease in plasma proteins, electrolytes, RBC and PCV relative to control fish, which may have resulted from surgically-induced hemorrhage. Plasma enzyme activities increased in response to anesthesia and surgery and may indicate general stress and tissue damage. Anesthesia had a greater effect on blood value response than surgery, and the proportion of effect increased with temperature as MS-222 potency and toxicity increases with water temperature. Repeated handling and blood draws within 24 h resulted in a 7% increase in cortisol, 10–14% increase in CK and 9–11% increase in LDH values. Except for plasma enzyme activities, blood values of all fish recovered within 1 week following anesthesia and surgeries. Relative experience of surgeons had no effect on hematology and biochemistry of fish, but healing rates of incisions were improved with better suture technique. Results of this study conclude that the physiological effects of laparoscopy are largely related to the anesthetic, MS-222, and are generally mild and short-lived. Improvements in laparoscopic technique might be gained by exploring alternate anesthetic protocols with faster induction and recovery times and reduced physiological effects.