Orf is one of the most widespread viral diseases worldwide, affecting mostly small ruminants and, sometimes, other species, including wild animals. Of late, there have been an increasing number of reports of new species being affected by the disease, implying a dynamic host-pathogen interaction. The causative agent, orf virus, has been extensively investigated over recent years, owing to its zoonotic importance and ability to cross-infect other species sporadically. The evasive mechanisms that the virus has developed to adapt and grow in the presence of an active immune response helps to explain the ability of the virus to repeatedly reinfect the same host. The apparent diversity in the antigenic/immune targets of different orf virus strains involved in such repeat infections may also be contributing factors. Exposure of animals to stress or immunosupression as a result of therapy or primary viral infection can accentuate the severity of disease. Genes homologous to host cytokines or their antagonists, and which contribute to viral virulence, have been found in the viral genome. A combination of electron microscopy, histology and PCR is the most accurate laboratory approach for confirmation of the disease, although clinical signs are often typical. However, some infections may be confounded by similar clinical manifestations caused by other infections. This review presents, in brief, a recent understanding of the virus at the host-pathogen level, molecular biology of the virus, disease epidemiology, clinical manifestations in man and animals, diagnostic procedures, and the economic and environmental impact of the disease.