The monoclonal antibody (mAb) revolution that currently provides many new options for the treatment of neoplastic and inflammatory diseases has largely bypassed the field of infectious diseases. Only one mAb is licensed for use against an infectious disease, although there are many in various stages of development. This situation is peculiar given that serum therapy was one of the first effective treatments for microbial diseases and that specific antibodies have numerous antimicrobial properties. The underdevelopment and underutilization of mAb therapies for microbial diseases has various complex explanations that include the current availability of antimicrobial drugs, small markets, high costs and microbial antigenic variation. However, there are signs that the climate for mAb therapeutics in infectious diseases is changing given increasing antibiotic drug resistance, the emergence of new pathogenic microbes for which no therapy is available, and development of mAb cocktail formulations. Currently, the major hurdle for the widespread introduction of mAb therapies for microbial diseases is economic, given the high costs of immunoglobulin preparations and relatively small markets. Despite these obstacles there are numerous opportunities for mAb development against microbial diseases and the development of radioimmunotherapy provides new options for enhancing the magic bullet. Hence, there is cautious optimism that the years ahead will see more mAbs in clinical use against microbial diseases.The field of infectious diseases has largely missed the monoclonal antibody (mAb) therapeutic revolution of the past decade. In contrast to such fields as oncology and rheumatology where mAbs have provided new effective therapies, only one mAb has been licensed for the treatment of an infectious disease [1]. This omission in the anti-infective armamentarium is particularly distressing given that the therapy of infectious disease is in crisis, since it is arguably the only field of medicine where effective intervention options have declined [2]. The crisis in infectious disease therapeutics is a consequence of four simultaneous developments, that in combination have significantly reduced treatment options for certain microbial diseases: 1) widespread antimicrobial drug resistance; 2) an epidemic of immunocompromised hosts in whom antimicrobial therapy is not as effective as in hosts with intact immunity; 3) the emergence of new pathogenic microbes for which no therapy exists; and 4) the re-emergence of older pathogenic microbes, often in drug-resistant form, as exemplified by multidrug-resistant (MDR) Mycobacterium tuberculosis.