Abstract: Leishmaniases range over the intertropical zones of America and Africa, and extend into temperate regions of Latin America, Southern Europe and Asia. About 20 named Leishmania species and subspecies are pathogenic for humans and are annually responsible for 1-1.5 million cases of cutaneous (CL) and 0.5 million cases of visceral (VL) forms of the disease. Thirty sandfly species are proven vectors. The epidemiology is largely diverse, being the agents and related diseases grouped into several zoonotic or anthroponotic entities. Southern European countries are mainly affected by zoonotic VL and sporadic CL, both caused by different strains of L. infantum. About 4,700 leishmaniasis cases were reported in the region over the past 10 years, the highest number being recorded in Italy (1,677). Acute VL is diagnosed in children in a proportion varying from 30% (Southern France) to over 60% (Albania) of all recorded cases. The region was particularly affected by an increasing incidence of HIV/VL co-infections until the late 1990s, but after the introduction of the HAART therapy the incidence rates were considerably reduced. VL is also frequently recorded in adults with other immunosuppressive conditions, e.g. treatments for organ transplant or immunological disorders and malignancies. L. infantum is widespread in the canine reservoir, several thousands infected dogs being annually diagnosed in the endemic zones. The proven VL vectors in Southern Europe are five species of the subgenus Phlebotomus (Larroussius): P. perniciosus Newstead, P. ariasi Tonnoir, P. perfiliewi Parrot, P. neglectus Tonnoir and P. tobbi Adler and Theodor, differently distributed in the region. Some of them have increased in density and expanded their geographic range over the past 15 years, suggesting a northward spreading of L. infantum transmission. The burden of leishmaniases in endemic countries bordering Europe at the South (Afro-Mediterranean region) and South-East (Turkey, Near and Middle East) is much higher than in Southern Europe. Zoonotic CL caused by L. major and anthroponotic CL caused by L. tropica affect thousands individuals in rural and urban areas. These agents are frequently identified in imported cases and, because of the presence of susceptible vectors, the risk for the introduction of new parasites into leishmaniasis-endemic zones of Southern Europe should not be underestimated.