While some historians have noted the absence of animals in medical history, few have made the animal the central object of their historical gaze. Twenty years ago W.F. Bynum urged medical historians to follow historians of science in paying attention to the role of non-human animals in the material practices of medicine. Yet few have responded to his call. In this paper we again ask the question: what work can the non-human animal achieve for the history of medicine? We do so in the light of the conceptual possibilities opened up by the rapidly emerging field of ‘animal studies’. This interdisciplinary and sophisticated body of work has, in various ways, revealed the value of the ‘animal’ as a tool for exploring the co-constitution of species identity. We asked ourselves, surely, in our present biomedical world, this must be an area that we as medical historians are best placed to comment on; and what better place to start than the well-known, yet surprisingly little-studied, medical leech?