This paper reviews paleo- and archaeoparasitology publications to date, from Iran. The primary focus is the importance of differential diagnosis and the crucial role of interdisciplinary collaborations among parasitologists and other specialists.All relevant articles and theses published in Iran through October 2020 are included and evaluated, with particular emphasis on the diagnostic process.Archaeoparasitic studies in Iran have identified a number of parasites that provide insight into the past. Misidentification, however, due to incomplete differential diagnosis, remains an issue, as does incomplete description and problematic images.Identification of paleoparasites to the species level must be supported with accurate morphology and morphometry. Rigorous differential diagnosis is essential. Caution must be exercised when interpreting observations of ova recovered from coprolites. In these instances, precise identification of host animals and aligning parasite ranges with host specificity is critical. The possibility of incidental parasite presence must be evaluated, including non-specificity of parasite tropisms, transport hosting, or contamination. Lastly, differential diagnosis must include consideration of intentional consumption of parasites. Thus, parasitological findings must be placed in geographical, historical, and cultural contexts.Archaeoparasitological research in Iran has elucidated the presence of faunal and human disease in the past and has, through this reevaluation of the published works, contributed to precise description and diagnosis of ova of roundworms, tapeworms, thorny-headed worms, and recognition of larval stages of tapeworms in recovered remains of mites.