A systematic review of the parasites, pathogens and commensals of the edible cockle (Cerastoderma edule) and of the lagoon cockle (Cerastoderma glaucum) has been completed. A total of 59 different conditions have been reported throughout the range of both of these hosts; of these 50 have been reported in edible cockles, and 28 in lagoon cockles. Cockles are hosts to viruses, bacteria, fungi (including Microsporidia), Apicomplexa, Amoeba, Ciliophora, Perkinsozoa, Haplosporidia, Cercozoa, Turbellaria, Digenea, Cestoda, Nematoda, Crustacea and Nemertea. A number of these have been reported sporadically although they may be associated with mortalities. In particular, mortalities have been associated predominately with digeneans and some protistan infections. In many cases pathology is marked in affected animals and parasites have been shown to reduce fecundity, alter burrowing behaviour and limit growth. This review provides information on the individual and population effects of these conditions as well as providing suggestions for future research. In particular, there has been a lack of taxonomic rigour applied to many studies and as a result there are a number of erroneous host records. There is a need to re-describe a number of parasite species and to determine the life cycle of those considered to be important mortality drivers.