Adipose tissue (AT) is no longer regarded as an inert lipid storage, but as an important central regulator in energy homeostasis and in immunity. Three parasite species are uniquely associated with AT during part of their life cycle: Trypanosoma cruzi, the causative agent of Chagas disease, Trypanosoma brucei, the cause of African sleeping sickness and Plasmodium spp, the cause of malaria. In the AT, T. cruzi resides inside adipocytes, T. brucei is found in the interstitial spaces between adipocytes, while Plasmodium spp. infect red blood cells that may adhere to the blood vessels supplying AT. We will discuss how each parasite species adapts to this tissue environment and what the implications are for pathogenesis, clinical manifestations and therapy.