A risk framework has been developed to examine the influence of climate change on disease emergence in the United Kingdom. The fish immune response and the replication of pathogens are often correlated with water temperature, which manifest as temperature ranges for infection and clinical diseases. These data are reviewed for the major endemic and exotic disease threats to freshwater fish. Increasing water temperatures will shift the balance in favour of either the host or pathogen, changing the frequency and distribution of disease. A number of endemic diseases of salmonids (e.g. enteric red mouth, furunculosis, proliferative kidney disease and white spot) will become more prevalent and difficult to control as water temperatures increase. Outbreaks of koi herpesvirus in carp fisheries are likely to occur over a longer period each summer. Climate change also alters the threat level associated with exotic pathogens. The risk of viral haemorrhagic septicaemia (VHSV), infectious haematopoietic necrosis virus (IHNV) and spring viraemia of carp virus (SVCV) declines as infection generally only establishes when water temperatures are less than 14°C for VHSV and IHNV and 17°C for SCVC. The risk of establishment of other exotic pathogens (epizootic haematopoietic necrosis and epizootic ulcerative syndrome) increases. The spread of Lactococcus garvieae northwards in Europe is likely to continue, and thus is more likely to be both introduced and become established. Measures to reduce the threat of exotic pathogens need to be revised to account for the changing exotic diseases threat. Increasing water temperatures and the negative effects of extreme weather events (e.g. storms) are likely to alter the freshwater environment adversely for both wild and farmed salmonid populations, increasing their susceptibility to disease and the likelihood of disease emergence. For wild populations, surveillance and risk mitigation need to be focused on locations where disease emergence, as a result of climate change, is most likely.