Large carnivores are of vital importance to the stability and integrity of most ecosystems, but recent declines in free-ranging populations have highlighted the potentially devastating effect of infectious diseases on their conservation. We reviewed the literature on infectious diseases of 34 large (maximum body mass of adults >20 kg) terrestrial carnivore species, 18 of which are considered to be threatened in the wild, and examined reports of antibody prevalence (seroprevalence) and cases of infection, mortality and population decline. Of 52 diseases examined, 44% were viral, 31% bacterial and the remainder were protozoal or fungal. Many infections were endemic in carnivores and/or infected multiple taxonomic families, with the majority probably occurring via inhalation or ingestion. Most disease studies consisted of serological surveys for disease antibodies, and antibody detection tended to be widespread implying that exposure to micro-organisms was common. Seroprevalence was higher in tropical than temperate areas, and marginally higher for infections known to occur in multiple carnivore groups. Confirmation of active infection via micro-organism recovery was less common for ursids than other taxonomic groups. Published descriptions of disease-induced population decline or extinction were rare, and most outbreaks were allegedly the result of direct transmission of rabies or canine distemper virus (CDV) from abundant carnivore species to less-common large carnivores. We conclude that the threat of disease epidemics in large carnivores may be serious if otherwise lethal infections are endemic in reservoir hosts and transmitted horizontally among taxa. To prevent or mitigate future population declines, research efforts should be aimed at identifying both the diseases of potential importance to large carnivores and the ecological conditions associated with their spread and severity.