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The epidemiology of food borne disease is changing. New pathogens have emerged, and some have spread worldwide. The broad spectrum of food borne infections has changed dramatically over time, as well-established pathogens have been controlled or eliminated, and new ones have emerged. Food pathogens have been a cause of a large number of diseases worldwide and more so in developing countries. This has a major economic impact. The burden of food borne disease remains substantial. Most of these illnesses are not accounted for by known pathogens, so must remain to be discovered. Among the known food borne pathogens, those more recently identified predominate, suggesting that as more and more is learned about pathogens, and they come under control. In addition to the emergence or recognition of new pathogens, other trends include global pandemics of some food borne pathogens, the emergence of antimicrobial resistance, the identification of pathogens that are highly opportunistic, affecting only the most high-risk sub populations, and the increasing identification of large and dispersed outbreaks. Outbreak investigations and case-control studies of sporadic cases can identify sources of infection and guide the development of specific prevention strategies. Better understanding of how pathogens persist in animal reservoirs is also critical to successful long-term prevention. In the past, the central challenge of foodborne disease lay in preventing the contamination of human food with sewage or animal manure. In the future, prevention of foodborne disease will increasingly depend on controlling contamination of feed and water consumed by the animals themselves.