Canine babesiosis is a tick-borne disease that used to occur in Germany mainly in imported dogs, and in dogs that had travelled to an endemic region. In recent years, autochthonous babesiosis caused by Babesia canis has been increasingly diagnosed. The following review describes transmission, pathomechanism, clinical signs, laboratory changes, therapy, prognosis, and prevention of infections with B. canis. Due to the activity pattern of the tick Dermacentor reticulatus, most patients are presented in late summer to early winter and spring. The dogs present with lethargy, pale/icteric mucous membranes, fever, and often hemoglobinuria. Laboratory abnormalities include marked thrombocytopenia, mild to moderate hemolytic anemia, leukopenia, and, depending on organ involvement, azotemia, elevated liver enzyme activities, increased serum troponin, and pancreatic lipase. Diagnosis is usually made by detection of merozoites in blood smears and by PCR. Treatment consists of the administration of imidocarb, usually twice, and supportive treatment. The success of therapy should be monitored by PCR examination. Depending on the study, the mortality rate is as high as 15%. Correct and year-round tick prophylaxis is the most important measure to prevent infection with Babesia.