In the present chapter, we will emphasize the immune response in two compartments (Central nervous system and peripheral system) in two blood sucking leeches i.e., the medicinal leech and the bird leech Theromyzon tessulatum. In the medicinal leech, the neuroimmune response has been described in the context of septic trauma at the cellular and humoral levels through microglia, Toll-like, cannabinoids and chemoattractant factors activation and modulation. In the bird leech, the antimicrobial responses have been dissected at the cellular and molecular levels. Altogether, this chapter presents a complete integrate immune response from the brain and the systemic compartments with high similarity to the vertebrates one. These points that the neuroimmune and immune responses evolved sooner than can be expected.