Cholera is still a medical problem in several countries, leading to the death of a large number of affected individuals. Recent acquisitions on the epidemiology of Vibrio cholerae suggest that there is a risk of global spreading of the disease and of the development of new pathogenic strains. We have reviewed the most recent hypothesis on the ecology of cholera, in particular on the origin of epidemics. Recent developments in the fields of therapy and prophylaxis of cholera are also reported.