Canine heartworm disease is a cosmopolitan disease, endemic in Brazil and related to the coastal and peninsular areas of the state of Pernambuco. It is a disease with clinical behavior that can range from asymptomatic animals to animals with severe symptoms. As it is included in the group of vector-borne diseases and is distributed mainly in tropical and subtropical areas of the world, it is common for there to be co-infections with other varied diseases, such as Canine Leishmaniasis. As a result of specific studies on the disease in the state of Pernambuco, the objective of this work was to evaluate the clinical and epidemiological aspects of dogs with natural infection by Dirofilaria immitis from the state of Pernambuco. Serological evaluation by immunochromatography was carried out on 89 domestic dogs from six neighborhoods in the county of Ilha de Itamaracá (Pernambuco, Brazil) and a frequency of D. immitis filarial antigens was detected in 19.1% (17/89). it is concluded that the persistence of canine heartworm disease is concentrated in areas close to the outskirts, with a high human population density and dog owners. An evaluation of the frequency and symptoms of dogs naturally infected with D. Immitis and Leishmania infantum treated at the Veterinary Hospital of the Federal Rural University of Pernambuco (UFRPE) was also carried out. A frequency of 12.9% of Heartworm/Leishmaniasis co-infection was observed in 89 animals evaluated and these animals, once co-infected, showed more chronic inflammatory symptoms. Finally, an evaluation of the Clinical Profile of dogs naturally infected by D.immitis treated at a reference outpatient clinic for canine heartworm disease was carried out. 89 animals were evaluated between 2021 and 2023 and we commented that the profile is made up of animals without a defined breed, but also animals with breed; who present clinical signs characteristic of the disease, but also clinical signs never before reported; that the hematological findings may be consistent with the infection, but also with possible co-infections and that the echocardiographic findings may highlight associated comorbidities and that the cases come from endemic and non-endemic areas.