The syncytial cytoplasmic layer, termed the tegument, which covers the entire surface of adult schistosomes, is a major interface between the parasite and its host. Since schistosomes can survive for decades within the host bloodstream, they are clearly able to evade host immune responses, and their ability is dependent on the properties of the tegument surface. We review here the molecular organization and biochemical functions of the tegument, combining the extensive literature over the last three decades with recent proteomic studies. We have interpreted the organization of the tegument surface as bounded by a conventional plasma membrane overlain by a membrane-like secretion, the membranocalyx, with which host molecules can associate. The range of parasite proteins, glycans and lipids found in the surface complex is evaluated, together with the host molecules detected. We consider the way in which the tegument surface is formed after cercarial penetration into the skin, and changes that occur as parasites develop to maturity. Lastly, we review the evidence on surface dynamics and turnover.