The Lepetelloidea, a clade of small limpet-shaped gastropods, can be used as a case study in continental margin and deep-sea diversification. Lineages in this clade have been found associated with a combination of different substrates, including hydrothermal vents, seeps, wood, whale carcasses, polychaete tubes, chondrichthyan egg cases, seagrass rhizomes, algal holdfasts, crab carapaces, and sponges. Members of one lepetelloidean family, Lepetellidae, live on or inside empty tubes of members of the polychaete genus Hyalinoecia. The detailed morphology of a Mediterranean species, Lepetella sierrai Dantart & Luque 1944, was reconstructed in three dimensions from serial semi-thin sections and compared with that of eleven other members of Lepetellidae. The hermaphroditic lepetellid limpets possessed a ciliated seminal groove, distinct testis and ovary with a common distal gonoduct, and a seminal receptacle containing mature sperm. A unique alimentary tract, with huge esophageal pouches, no true stomach, an extensive multilobed midgut, and short intestine, was present. Additionally, a bacteriocyte system throughout the entire mantle rim was revealed via light and transmission electron microscopy. This is the first recognized evidence for intracellular microbial symbiosis in lepetelloidean limpets. Semi-thin sections showed evidence of a parasite, potentially a chitonophilid copepod, penetrating the body wall of the limpet. Hypotheses about reproductive biology, feeding, and symbiosis are presented based on anatomical features and knowledge of the habitat described herein.