The purpose of this study was to evaluate the physicochemical and microbiological stability of sausages produced from mechanically separated fish meat (MSM) obtained from Nile tilapia filleting residues. Different heat treatments (pasteurization or smoking) and packaging systems (conventional or vacuum) were used. The sausages were characterized for chemical composition, weight loss, water activity, instrumental texture and sensorial analysis. Additionally, microbiological analysis, instrumental color, pH, thiobarbituric acid reactive substances (TBARS) and total volatile base nitrogen (TVB-N) were assessed during storage. No presence of Escherichia coli, Salmonella sp. or coagulase-positive Staphylococcus was detected; however, the psychrotrophic count in pasteurized sausages exceeded the limits allowed for consumption. pH and lipid oxidation speed (TBARS) values were reduced when vacuum packaging was used. Volatile nitrogenous bases remained virtually constant during the storage period, and higher values were observed in smoked products. Pasteurized sausages remain stable for 10 and 15 days in conventional and vacuum packages, respectively, and smoked sausages remain stable for 25 and 45 days in conventional and vacuum packages, respectively.