The use of animals in therapeutic practices has been a reality throughout human history, although it is not yet a well understood phenomenon. The main objective of this study was to describe and analyze the use of medicinal fauna in Recife, Pernambuco State, Brazil. Many aspects were taken into account, such as the identification of the animals used, preparation of the zootherapeutic products, and the articulation between current popular practices and the history of zootherapy in the region. Data were collected through semi-structured, open-ended interviews conducted with folk specialists in three public markets of Recife. For purposes of historical revision, data were also taken from the books written by two naturalists who lived in Pernambuco during the Dutch occupation: Guilherme Piso and Jorge Marcgrave. During the survey in public markets, 18 ethnotaxonomic categories of animals were found to be in current use for the treatment of 12 diseases, according to the popular medicinal diagnosis. In these cases, the prescriptions were characterized by dosage recommendation, association with plant products, and certain cultural rules. Among these 18 ethnocategories, 9 were similar to those used in the 17th century. These were used, during the Dutch occupation, for the preparation of 9 different kinds of medicines, which treated 10 diseases. Nevertheless, in most cases the current popular prescriptions differ from those reported in the colonial period. The results show the strong persistence of zootherapy in the region, since the reported diseases take part in the daily life of poor local people. Further studies on this body of knowledge, beliefs and popular practices may be a helpful tool for medical and pharmaceutical investigations, as well as for a better understanding of the interaction between local people and natural resources and conservation, in a historical perspective.