This study was carried out to determine the health status of red tilapia cultured in green algae pond that does not show any signs of abnormality. A total of 30 red tilapia were sampled from indoor green algae pond located in Perak. The overall gross examination showed 29% of red tilapia have clinical signs such as haemorrhage, pale gill, pop eye and redness while enlarged liver, pale liver and enlarged spleen were observed at internal organs. No ectoparasite was found from gill and body smear examination. Bacteriology showed prevalence 28.5% infection comprising of Plesiomonas shillegoides, Pseudomonas putida, Edwarsiella tarda, Aeromonas sobria and Aeromonas hydrophila. Analysis on Tilapia Lake Virus (TiLV) using semi-nested RT-PCR showed 80% were positive and 62.5% of positive sample having similarity sequence of nucleotide DNA with TiLV. Sequencing analysis on nucleotide DNA showed 98% are identical to the strain from Thailand (KY381578) and 95% from Israel (KU751816). Histopathology of liver showed presence of 40% hepatocytes resembling giant cells which contained multiple nuclei and is a typical pathology for TiLV. Indicating that, red tilapia currently used for green algae production had bacterial infections and high prevalence of TiLV. Although no mortalities were reported so far, we believe that under sudden or prolong exposure changes may potentially cause mortality in red tilapia particularly those having positive TiLV.