Organometallic moieties make excellent candidates for lead structures in drug design, due to their bioactivity, redox chemistry and structural diversity. Despite this, only a limited number of organometallic compounds have been recruited in combatting neglected tropical diseases, 17 of which are officially recognised by the World Health Organisation. New pharmaceuticals are needed to overcome the prominent side effects of existing treatments for these diseases, as well as to avoid emerging resistance genes in the causative parasites. This review focuses on the use of organometallic drug compounds in treating African sleeping sickness (Human African trypanosomiasis), Chagas disease (American trypanosomiasis), leishmaniasis, schistosomiasis and echinococcosis. Studies from the past 5–10 years have generated promising lead compounds, most arising from the modification of an existing drug and all demonstrating the advantageous properties unique to organometallic chemistry. Most of the compounds introduced here remain in the lead identification stage and require further in vivo and physiochemical studies.