This review defines insecticide/acaricide resistance and describes the history, evolution, types, mechanisms, and detection of resistance as it applies to chemicals currently used against fleas and ticks of dogs and cats and summarizes resistance reported to date. We introduce the concept of refugia as it applies to flea and tick resistance and discuss strategies to minimize the impact and inevitable onset of resistance to newer classes of insecticides. Our purpose is to provide the veterinary practitioner with information needed to investigate suspected lack of efficacy, respond to lack of efficacy complaints from their clients, and evaluate the relative importance of resistance as they strive to relieve their patients and satisfy their clients when faced with flea and tick infestations that are difficult to resolve. We conclude that causality of suspected lack of insecticide/acaricide efficacy is most likely treatment deficiency, not resistance.