An investigation of the factors responsible for the distribution of Macoma balthica (L.) on a mudflat receiving sewage effluent was carried out in the Fraser River estuary, British Columbia. The factors examined included reduced salinity, low levels of dissolved oxygen, effluent toxicity, chlorination, substrate grain size and the effects of metal contaminated sediments. Results showed that salinity, dissolved oxygen and sediment grain size did not satisfactorily explain the distribution of M. balthica. Unchlorinated and chlorinated sewage effluent were shown to be non-toxic in laboratory tests, and these results were confirmed by 7-day in situ bioassays. The factor which appeared to determine the distribution of M. balthica was the degree of contamination of the substrate which affected the settling and survival of larval and juvenile clams. Heavy metals occurred in high concentrations in the contaminated sediments and were considered to be the most probable controlling factor.