American Trypanosomiasis or Chagas’ disease is endemic of the American continent with a wide distribution from the South of United States to North of Argentina. The etiological agent is the parasitic protozoan Trypanosoma cruzi which is transmitted by blood sucking triatomine bugs through contaminated feces. According to the last consensus meeting in 2009, T. cruzi has been divided in six groups or discrete typing units (DTU), also names genotypes, from TcI to TcVI. The geographical distribution of T. cruzi genotypes in the American Continent has some particularities. For instance, genotypes TcII, TcV and TcVI are found infecting humans at the Southern cone, whereas TcI and TcIV are the genotypes prevalent from the Amazon basin to Central and North America. In Latin America, for decades TIV was considered mainly sylvatic with very rare occasion of human infections. A recent study in Venezuela reported TcI, TcIII and TcIV circulating in domestic and sylvatic cycles, but only genotypes TcI and TcIV have been identified infecting humans in different regions of the country. Around 79% of the patients have been found infected with TcI and the remaining with TcIV. In this study we have made the follow up of 30 chronic chagasic patients showing that the clinical outcome of people infected with TcI shows to be more severe than those infected with TcIV, suggesting that TcI genotype is in general more pathogenic than TcIV. We have detected triatomine bugs and wild mammals naturally infected with TcIII, but no human infection with this genotype has been identified so far. Murine models indicate that T. cruzi isolates belonging to TcI genotype shows to be more virulent and pathogenic than TcIV. The biological behavior of TcI and TcIV isolates indicate a significant association with the clinical manifestation in the chronic patients.