The endoplasmic reticulum (ER) has unique properties that are exploited by microbial pathogens. Exotoxins secreted by bacteria take advantage of the host transport pathways that deliver proteins from the Golgi to the ER. Transport to the ER is necessary for the unfolding and translocation of these toxins into the cytosol where their host targets reside. Intracellular pathogens subvert host vesicle transport to create ER-like vacuoles that support their intracellular replication. Investigations on how bacterial pathogens can use the ER during host infection are providing important details on transport pathways involving this specialized organelle.