Freshwater mussels are one of the most endangered animal groups globally, making them a high conservation priority. Conservationists increasingly employ translocation or captive breeding procedures to support ailing populations, and the ecosystem engineering capabilities of mussels are being increasingly harnessed in bioremediation projects. However, there is little consideration of the risk of pathogen transmission when moving mussels from hatcheries or wild donor populations into new habitats. This is of significant concern as recent developments suggest parasites and diseases are highly prevalent and have contributed to several mass population‐level die‐offs. Here, we explicitly highlight the risks of pathogen spread in mussel translocations, explore how these risks are mediated, and provide recommendations for both research and action to avoid the inadvertent spread of virulent pathogens when conserving vulnerable mussel populations. While targeted at freshwater conservationists, this perspective has relevance for considering translocation‐mediated disease and parasite spread in any study system.