Filarial worm parasites of humans cause devastating morbitities and contribute to the loss of millions of disability associated life years, whilst drug prevention of veterinary heartworm disease in pets is a multi-billion dollar market. The microbiome of filarial worms includes the well-described endosymbiotic rickettsial bacteria, Wolbachia, as well as a variety of newly discovered RNA viruses. The presence of these microorganism hitch-hikers within filarial parasites presents opportunities for a new, more complex understanding of filarial disease aetiology as well as offering attractive targets for new drug therapeutic strategies. Here I will give an overview of our understanding of how the filarial 'microbiome' may shape disease and describe the anti-Wolbachia drug program which is developing both new chemical entity candidates and repurposed antibiotics as new strategies to prevent or cure filarial infections.