This review examines the significant literature on the immunology and pathology of intestinal trematodes in their definitive hosts. We emphasize information on selected species in six families for which the literature on these topics is extensive. The families are Brachylaimidae, Diplostomidae, Echinostomatidae, Gymnophallidae, Heterophyidae, and Paramphistomidae. For most of these families, coverage is considered under the following headings: (i) background; (ii) pathology of the infection; (iii) immunology of the infection; (iv) immunodiagnosis; and (v) human infection. Some of these heading have been subdivided further, based on the literature available on a particular topic. Following this coverage, we include a final section on the important topical literature on selected trematodes in families other than the six mentioned above.