One billion people worldwide are affected by fungal pathogens, of which 1.6 million succumb to fungal infections per year. This review discusses the emergence and evolution of fungal pathogenesis in humans in the form of opportunistic commensal and environmental fungi. We explore the attributes that contribute to their success as pathogens and the scenarios which may have caused the evolutionary selection of virulence factors. This includes antivirulence and avirulence genes, notions that are new for fungal pathogens of humans but which are based on well established concepts in bacterial pathogens and phytopathogenic fungi. These ideas will ultimately help us to better understand the pathogenicity of fungi that infect humans: from the emergence to the finer adjustment of virulence to promote pathogen persistence.