Leptospirosis is arguably the most widespread zoonosis; it is also a major cause of economic loss in production animals worldwide. At the level of the host animal or human, the progression of infection and the onset of disease are well documented. However, the mechanisms of pathogenesis at the cellular and molecular level remain poorly understood, mainly as a result of the lack of modern genetic tools for mutagenesis of pathogenic Leptospira spp. The recent development of transposon mutagenesis and the construction of a very small number of directed leptospiral mutants have identified a limited number of essential virulence factors. Perhaps surprisingly, many leptospiral proteins with characteristics consistent with a role in virulence have been shown to not be required for virulence in animal models, consistent with a high degree of functional redundancy in pathogenic Leptospira. A large number of putative adhesins has been reported in Leptospira, which interact with a range of host tissue components; however, almost none of these have been genetically confirmed as having an essential role in pathogenesis.