Historical strandings and sightings (1989–2016) of Tursiops truncatus at 25oS in the south-western Atlantic Ocean (Paraná, Brazil) were assessed to (1) investigate temporal fluctuations; and (2) quantify biological, ecological and health parameters of regional populations. In total, 57 T. truncatus carcasses in mostly advanced stages of decomposition (~80% of all specimens) were recorded. Standardized temporal strandings (per observational effort) varied considerably and with no clear annual relationship beyond a peak in 2007, but there were consistently more strandings in winter/spring (74%) than summer/autumn (26%). While there was uncertainty over age estimation (i.e. not available for the population), individuals classified as juveniles/subadults were more frequent (80%) than calves (14%) and adults (6%). Of 28 carcasses assessed, 27 showed a positive linear relationship between TL and condyle-basal length, while one specimen had a clear southern skull morphotype. Suggestive lesions of Crassicauda sp. were recorded in 77% of assessed skulls and four types of tooth pathologies were observed. Nine individuals were more closely investigated for gross and histopathological alterations and had clear evidence of fishery interactions and various health issues associated with disease and oedema accompanied by alveolar fibrosis. While the regional frequency of T. truncatus strandings was lower than other more vulnerable cetaceans, the absolute numbers (e.g. 15 individuals in 2016) and some uncertainty concerning regional taxonomy are noteworthy, and justify ongoing spatio-temporal monitoring. Further, given the evidence of disease in some specimens, future work should not only encompass rigorous taxonomic assessments, but also health to comprehensively evaluate regional stocks. Small cetacean species are sentinels and their condition could inform ongoing environmental assessments.