Bacillus anthracis, the causative agent of anthrax, has a particular strategy for invading the host and crossing the alveolar barrier. B. anthracis survives within alveolar macrophages, after germination within the phagolysosome, then enters the external medium where it proliferates. Recent data have shown that edema toxin and lethal toxin are the major genetic determinants mediating the survival of germinated spores within macrophages. Here, recent advances in the analysis of B. anthracis pathogenesis are summarized and future challenges discussed.