Leptospirosis is an emerging zoonotic disease caused by pathogenic Leptospira spp., affecting a wide range of domestic and wild mammals including nonhuman primates (NHPs). Despite rising incidence rates in both NHPs and humans, there is a lack of comprehensive resources addressing leptospirosis in NHPs from a veterinary perspective in a One Health approach. The close phylogenetic relationship between NHPs, humans and the similarities in disease progression may reveal valuable insights into the pathophysiology, diagnosis, treatment, control measures, and surveillance of leptospirosis. This review synthesizes existing literature on leptospirosis in NHPs, focusing on diagnosis, control measures, and surveillance. It offers insights into the prevalence among NHPs, environmental and civilization factors affecting Leptospira spp. dynamics, and recommendations for the diagnosis, management, and monitoring of leptospirosis. The findings highlight the need for coordinated research efforts and integrated surveillance systems to reduce leptospirosis risk in NHPs. © 2025 The Author(s). Journal of Medical Primatology published by John Wiley & Sons Ltd.