Landscape ecology examines the relationships between the spatial arrangement of different landforms and the processes that give rise to spatial and temporal patterns in local community structure. These relationships that underlie the patterns of the microbial communities that inhabit the human body, and in particular, those of the nose, mouth and throat, deserve greater attention. Important questions include what defines the size of a population (i.e., ‘patch’) in a given body site; what defines the boundaries of distinct patches within a single body site, and where and over what spatial scales within a body site are gradients detected. This review looks at the landscape ecology in the upper respiratory tract and mouth, and seeks greater clarity about the physiological factors, whether immunological, chemical or physical, that govern microbial community composition and function, and the ecological traits that underlie health and disease.