More than 300 million people suffer from a range of diseases caused by gastropod-borne helminths, predominantly flatworms and roundworms, whose life cycles are characterized by a diversified ecology and epidemiology. Despite the plethora of data on these parasites, very little is known of the fundamental biology of their gastropod intermediate hosts, or of the interactions occurring at the snail-helminth interface. In this article, we focus on schistosomes and metastrongylids of human and animal significance, and review current knowledge of snail-parasite interplay. Future efforts aimed at elucidating key elements of the biology and ecology of the snail intermediate hosts, together with an improved understanding of snail-parasite interactions, will aid to identify, plan, and develop new strategies for disease control focused on gastropod intermediate hosts.