Leishmaniasis, a vector-borne parasitic disease resulting from infection of macrophages by obligate intracellular parasites of genus Leishmania, has been considered a major tropical disease by the World Health Organization. Generic pentavalent antimonials have been the mainstay for therapy in the endemic regions because of its efficacy and cost effectiveness. However, the growing incidence of resistance for the pentavalent antimony complex in endemic and non-endemic regions has seriously hampered their use in these regions. The second line drugs such as amphotericin B, paromomycin and miltefosine are the other alternatives, but they merely fulfill the desired requirements of a safe drug. The recent researches focused on plants have shown a wise way to get a true and potentially rich source of drug candidates against leishmaniasis, where alkaloids have been found more effective. The present review initially highlights the current status of leishmaniasis, synergy of the disease with HIV, therapeutic options available and in later sections summarizes all alkaloids, which have shown significant antileishmanial activities.