The intention of this article is not to describe the illness or evaluate the number of cases diagnosed in Spain, Switzerland and Italy, nor to analyse the protocols followed in various centres. The authors rather seek to examine the main technical, local and national challenges involved in the care of patients with Chagas disease. To this end, they review concisely a number of themes which are common to the three countries. These are: the detection of disease; confirmation of the diagnosis; treatment; response to treatment; follow-up; the risk of transmission by transfusion, by organ donation and from mother to child; the psychosocial and socio-economic aspects of Chagas disease outside endemic areas; and what progress needs to be made in improving information about the condition.