Climate change is predicted to have important effects on parasitism and disease in freshwater and marine ecosystems, with consequences for human health and socio-economics. The distribution of parasites and pathogens will be directly affected by global warming, but also indirectly, through effects on host range and abundance. To date, numerous disease outbreaks, especially in marine organisms, have been associated with climatic events such as the El Niño-Southern Oscillation. In general, transmission rates of parasites and pathogens are expected to increase with increasing temperature. Evidence suggests that the virulence of some pathogens and parasites may also increase with global warming. The effects of climate change on parasites and pathogens will be superimposed onto the effects of other anthropogenic stressors in ecosystems, such as contaminants, habitat loss and species introductions. This combination of stressors may work cumulatively or synergistically to exacerbate negative effects on host organisms and populations. Climatic effects on parasites and diseases of key species may cascade through food webs, with consequences for entire ecosystems.