For parasitic platyhelminths that generally lack a fossil record, there is little information on the pathways of morphological change during evolution. Polystomatid monogeneans are notable for their evolutionary diversification, having originated from ancestors on fish and radiated in parallel with tetrapod vertebrates over more than 425 million years (My). This study focuses on the genus Polystomoides that occurs almost worldwide on freshwater chelonian reptiles. Morphometric data show a major divergence in structural adaptations for attachment; this correlates with a dichotomy in micro-environmental conditions in habitats within the hosts. Species infecting the urinary tract have attachment organs with large hamuli and small suckers; species in the oro-nasal tract differ fundamentally, having small hamuli and large suckers. Zoogeographical and molecular evidence supports ancient separation of these site-specific clades: a new genus is proposed – Uropolystomoides – containing urinary tract species distinct from Polystomoides sensu stricto in oro-nasal sites. Aside from differences in attachment adaptations, body plans have probably changed little over perhaps 150 My. This case contrasts markedly with polystomatids in other vertebrate groups where major morphological changes have evolved over much shorter timescales; the chelonian parasites show highly stable morphology across their global distribution over a long period of evolution, exemplifying ‘living fossils’.