This paper gives an up-to-date review on delusional parasitosis (DP) and particularly meets clinical interests. Facing the lack of clear guidelines for clinical practice an efficient diagnostic staircase procedure is presented. The different approaches in the therapy of DP are reviewed and summed up in a checklist. The available information on the therapeutic gold standard, the neuroleptic agent pimozide, is discussed. Symptoms and clinical characteristics of DP are presented partly based on material from an internet website run by patients. Moreover, this paper delivers a comprehensive literature review on the pathogenesis of DP and its classification. To conclude, possible future therapies in DP, e. g. serotonin-dopamine-antagonists, as well as current methods in research on hallucinations are discussed.