diff --git a/setup.py b/setup.py
index 8877556..b951c18 100644
--- a/setup.py
+++ b/setup.py
@@ -31,6 +31,7 @@ def read(fname):
     ],
     python_requires='~=3.4',
     install_requires=[
+        'filelock>=3.0',
         'pytest>=2.8,<4.7; python_version<"3.5"',
         'pytest>=2.8; python_version>="3.5"',
         'mypy>=0.500,<0.700; python_version<"3.5"',
diff --git a/src/pytest_mypy.py b/src/pytest_mypy.py
index 3bff367..017a1b6 100644
--- a/src/pytest_mypy.py
+++ b/src/pytest_mypy.py
@@ -1,7 +1,10 @@
 """Mypy static type checker plugin for Pytest"""
 
+import json
 import os
+from tempfile import NamedTemporaryFile
 
+from filelock import FileLock
 import pytest
 import mypy.api
 
@@ -20,11 +23,44 @@ def pytest_addoption(parser):
         help="suppresses error messages about imports that cannot be resolved")
 
 
+def _is_master(config):
+    """
+    True if the code running the given pytest.config object is running in
+    an xdist master node or not running xdist at all.
+    """
+    return not hasattr(config, 'slaveinput')
+
+
 def pytest_configure(config):
     """
-    Register a custom marker for MypyItems,
+    Initialize the path used to cache mypy results,
+    register a custom marker for MypyItems,
     and configure the plugin based on the CLI.
     """
+    if _is_master(config):
+
+        # Get the path to a temporary file and delete it.
+        # The first MypyItem to run will see the file does not exist,
+        # and it will run and parse mypy results to create it.
+        # Subsequent MypyItems will see the file exists,
+        # and they will read the parsed results.
+        with NamedTemporaryFile(delete=True) as tmp_f:
+            config._mypy_results_path = tmp_f.name
+
+        # If xdist is enabled, then the results path should be exposed to
+        # the slaves so that they know where to read parsed results from.
+        if config.pluginmanager.getplugin('xdist'):
+            class _MypyXdistPlugin:
+                def pytest_configure_node(self, node):  # xdist hook
+                    """Pass config._mypy_results_path to workers."""
+                    node.slaveinput['_mypy_results_path'] = \
+                        node.config._mypy_results_path
+            config.pluginmanager.register(_MypyXdistPlugin())
+
+    # pytest_terminal_summary cannot accept config before pytest 4.2.
+    global _pytest_terminal_summary_config
+    _pytest_terminal_summary_config = config
+
     config.addinivalue_line(
         'markers',
         '{marker}: mark tests to be checked by mypy.'.format(
@@ -45,46 +81,6 @@ def pytest_collect_file(path, parent):
     return None
 
 
-def pytest_runtestloop(session):
-    """Run mypy on collected MypyItems, then sort the output."""
-    mypy_items = {
-        os.path.abspath(str(item.fspath)): item
-        for item in session.items
-        if isinstance(item, MypyItem)
-    }
-    if mypy_items:
-
-        terminal = session.config.pluginmanager.getplugin('terminalreporter')
-        terminal.write(
-            '\nRunning {command} on {file_count} files... '.format(
-                command=' '.join(['mypy'] + mypy_argv),
-                file_count=len(mypy_items),
-            ),
-        )
-        stdout, stderr, status = mypy.api.run(
-            mypy_argv + [str(item.fspath) for item in mypy_items.values()],
-        )
-        terminal.write('done with status {status}\n'.format(status=status))
-
-        unmatched_lines = []
-        for line in stdout.split('\n'):
-            if not line:
-                continue
-            mypy_path, _, error = line.partition(':')
-            try:
-                item = mypy_items[os.path.abspath(mypy_path)]
-            except KeyError:
-                unmatched_lines.append(line)
-            else:
-                item.mypy_errors.append(error)
-        if any(unmatched_lines):
-            color = {"red": True} if status != 0 else {"green": True}
-            terminal.write_line('\n'.join(unmatched_lines), **color)
-
-        if stderr:
-            terminal.write_line(stderr, red=True)
-
-
 class MypyItem(pytest.Item, pytest.File):
 
     """A File that Mypy Runs On."""
@@ -94,12 +90,28 @@ class MypyItem(pytest.Item, pytest.File):
     def __init__(self, *args, **kwargs):
         super().__init__(*args, **kwargs)
         self.add_marker(self.MARKER)
-        self.mypy_errors = []
 
     def runtest(self):
         """Raise an exception if mypy found errors for this item."""
-        if self.mypy_errors:
-            raise MypyError('\n'.join(self.mypy_errors))
+        results = _cached_json_results(
+            results_path=(
+                self.config._mypy_results_path
+                if _is_master(self.config) else
+                self.config.slaveinput['_mypy_results_path']
+            ),
+            results_factory=lambda:
+                _mypy_results_factory(
+                    abspaths=[
+                        os.path.abspath(str(item.fspath))
+                        for item in self.session.items
+                        if isinstance(item, MypyItem)
+                    ],
+                )
+        )
+        abspath = os.path.abspath(str(self.fspath))
+        errors = results['abspath_errors'].get(abspath)
+        if errors:
+            raise MypyError('\n'.join(errors))
 
     def reportinfo(self):
         """Produce a heading for the test report."""
@@ -119,8 +131,70 @@ def repr_failure(self, excinfo):
         return super().repr_failure(excinfo)
 
 
+def _cached_json_results(results_path, results_factory=None):
+    """
+    Read results from results_path if it exists;
+    otherwise, produce them with results_factory,
+    and write them to results_path.
+    """
+    with FileLock(results_path + '.lock'):
+        try:
+            with open(results_path, mode='r') as results_f:
+                results = json.load(results_f)
+        except FileNotFoundError:
+            if not results_factory:
+                raise
+            results = results_factory()
+            with open(results_path, mode='w') as results_f:
+                json.dump(results, results_f)
+    return results
+
+
+def _mypy_results_factory(abspaths):
+    """Run mypy on abspaths and return the results as a JSON-able dict."""
+
+    stdout, stderr, status = mypy.api.run(mypy_argv + abspaths)
+
+    abspath_errors, unmatched_lines = {}, []
+    for line in stdout.split('\n'):
+        if not line:
+            continue
+        path, _, error = line.partition(':')
+        abspath = os.path.abspath(path)
+        if abspath in abspaths:
+            abspath_errors[abspath] = abspath_errors.get(abspath, []) + [error]
+        else:
+            unmatched_lines.append(line)
+
+    return {
+        'stdout': stdout,
+        'stderr': stderr,
+        'status': status,
+        'abspath_errors': abspath_errors,
+        'unmatched_stdout': '\n'.join(unmatched_lines),
+    }
+
+
 class MypyError(Exception):
     """
     An error caught by mypy, e.g a type checker violation
     or a syntax error.
     """
+
+
+def pytest_terminal_summary(terminalreporter):
+    """Report stderr and unrecognized lines from stdout."""
+    config = _pytest_terminal_summary_config
+    try:
+        results = _cached_json_results(config._mypy_results_path)
+    except FileNotFoundError:
+        # No MypyItems executed.
+        return
+    if results['unmatched_stdout'] or results['stderr']:
+        terminalreporter.section('mypy')
+        if results['unmatched_stdout']:
+            color = {'red': True} if results['status'] else {'green': True}
+            terminalreporter.write_line(results['unmatched_stdout'], **color)
+        if results['stderr']:
+            terminalreporter.write_line(results['stderr'], yellow=True)
+    os.remove(config._mypy_results_path)
diff --git a/tests/test_pytest_mypy.py b/tests/test_pytest_mypy.py
index 35378ec..1fd4de4 100644
--- a/tests/test_pytest_mypy.py
+++ b/tests/test_pytest_mypy.py
@@ -1,25 +1,47 @@
-def test_mypy_success(testdir):
+import pytest
+
+
+@pytest.fixture(
+    params=[
+        True,  # xdist enabled, active
+        False,  # xdist enabled, inactive
+        None,  # xdist disabled
+    ],
+)
+def xdist_args(request):
+    if request.param is None:
+        return ['-p', 'no:xdist']
+    return ['-n', 'auto'] if request.param else []
+
+
+@pytest.mark.parametrize('test_count', [1, 2])
+def test_mypy_success(testdir, test_count, xdist_args):
     """Verify that running on a module with no type errors passes."""
-    testdir.makepyfile('''
-        def myfunc(x: int) -> int:
-            return x * 2
-    ''')
-    result = testdir.runpytest_subprocess()
+    testdir.makepyfile(
+        **{
+            'test_' + str(test_i): '''
+                def myfunc(x: int) -> int:
+                    return x * 2
+            '''
+            for test_i in range(test_count)
+        }
+    )
+    result = testdir.runpytest_subprocess(*xdist_args)
     result.assert_outcomes()
-    result = testdir.runpytest_subprocess('--mypy')
-    result.assert_outcomes(passed=1)
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
+    result.assert_outcomes(passed=test_count)
     assert result.ret == 0
 
 
-def test_mypy_error(testdir):
+def test_mypy_error(testdir, xdist_args):
     """Verify that running on a module with type errors fails."""
     testdir.makepyfile('''
         def myfunc(x: int) -> str:
             return x * 2
     ''')
-    result = testdir.runpytest_subprocess()
+    result = testdir.runpytest_subprocess(*xdist_args)
     result.assert_outcomes()
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
     result.assert_outcomes(failed=1)
     result.stdout.fnmatch_lines([
         '2: error: Incompatible return value*',
@@ -27,7 +49,7 @@ def myfunc(x: int) -> str:
     assert result.ret != 0
 
 
-def test_mypy_ignore_missings_imports(testdir):
+def test_mypy_ignore_missings_imports(testdir, xdist_args):
     """
     Verify that --mypy-ignore-missing-imports
     causes mypy to ignore missing imports.
@@ -35,32 +57,35 @@ def test_mypy_ignore_missings_imports(testdir):
     testdir.makepyfile('''
         import pytest_mypy
     ''')
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
     result.assert_outcomes(failed=1)
     result.stdout.fnmatch_lines([
         "1: error: Cannot find *module named 'pytest_mypy'",
     ])
     assert result.ret != 0
-    result = testdir.runpytest_subprocess('--mypy-ignore-missing-imports')
+    result = testdir.runpytest_subprocess(
+        '--mypy-ignore-missing-imports',
+        *xdist_args
+    )
     result.assert_outcomes(passed=1)
     assert result.ret == 0
 
 
-def test_mypy_marker(testdir):
+def test_mypy_marker(testdir, xdist_args):
     """Verify that -m mypy only runs the mypy tests."""
     testdir.makepyfile('''
         def test_fails():
             assert False
     ''')
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
     result.assert_outcomes(failed=1, passed=1)
     assert result.ret != 0
-    result = testdir.runpytest_subprocess('--mypy', '-m', 'mypy')
+    result = testdir.runpytest_subprocess('--mypy', '-m', 'mypy', *xdist_args)
     result.assert_outcomes(passed=1)
     assert result.ret == 0
 
 
-def test_non_mypy_error(testdir):
+def test_non_mypy_error(testdir, xdist_args):
     """Verify that non-MypyError exceptions are passed through the plugin."""
     message = 'This is not a MypyError.'
     testdir.makepyfile('''
@@ -71,15 +96,15 @@ def _patched_runtest(*args, **kwargs):
 
         pytest_mypy.MypyItem.runtest = _patched_runtest
     '''.format(message=message))
-    result = testdir.runpytest_subprocess()
+    result = testdir.runpytest_subprocess(*xdist_args)
     result.assert_outcomes()
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
     result.assert_outcomes(failed=1)
     result.stdout.fnmatch_lines(['*' + message])
     assert result.ret != 0
 
 
-def test_mypy_stderr(testdir):
+def test_mypy_stderr(testdir, xdist_args):
     """Verify that stderr from mypy is printed."""
     stderr = 'This is stderr from mypy.'
     testdir.makepyfile(conftest='''
@@ -90,11 +115,11 @@ def _patched_run(*args, **kwargs):
 
         mypy.api.run = _patched_run
     '''.format(stderr=stderr))
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
     result.stdout.fnmatch_lines([stderr])
 
 
-def test_mypy_unmatched_stdout(testdir):
+def test_mypy_unmatched_stdout(testdir, xdist_args):
     """Verify that unexpected output on stdout from mypy is printed."""
     stdout = 'This is unexpected output on stdout from mypy.'
     testdir.makepyfile(conftest='''
@@ -105,16 +130,39 @@ def _patched_run(*args, **kwargs):
 
         mypy.api.run = _patched_run
     '''.format(stdout=stdout))
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
     result.stdout.fnmatch_lines([stdout])
 
 
-def test_api_mypy_argv(testdir):
+def test_api_mypy_argv(testdir, xdist_args):
     """Ensure that the plugin can be configured in a conftest.py."""
     testdir.makepyfile(conftest='''
         def pytest_configure(config):
             plugin = config.pluginmanager.getplugin('mypy')
             plugin.mypy_argv.append('--version')
     ''')
-    result = testdir.runpytest_subprocess('--mypy')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
+    assert result.ret == 0
+
+
+def test_pytest_collection_modifyitems(testdir, xdist_args):
+    testdir.makepyfile(conftest='''
+        def pytest_collection_modifyitems(session, config, items):
+            plugin = config.pluginmanager.getplugin('mypy')
+            for mypy_item_i in reversed([
+                    i
+                    for i, item in enumerate(items)
+                    if isinstance(item, plugin.MypyItem)
+            ]):
+                items.pop(mypy_item_i)
+    ''')
+    testdir.makepyfile('''
+        def myfunc(x: int) -> str:
+            return x * 2
+
+        def test_pass():
+            pass
+    ''')
+    result = testdir.runpytest_subprocess('--mypy', *xdist_args)
+    result.assert_outcomes(passed=1)
     assert result.ret == 0
diff --git a/tox.ini b/tox.ini
index 1e39cde..c053b37 100644
--- a/tox.ini
+++ b/tox.ini
@@ -13,34 +13,58 @@ envlist =
 [testenv]
 deps =
     pytest2.8: pytest ~= 2.8.0
+    pytest2.8: pytest-xdist < 1.18.0
     pytest2.x: pytest ~= 2.8
+    pytest2.x: pytest-xdist < 1.18.0
     pytest3.0: pytest ~= 3.0.0
+    pytest3.0: pytest-xdist < 1.19.0
     pytest3.1: pytest ~= 3.1.0
+    pytest3.1: pytest-xdist < 1.19.0
     pytest3.2: pytest ~= 3.2.0
+    pytest3.2: pytest-xdist < 1.19.0
     pytest3.3: attrs < 19.2.0  # https://github.com/pytest-dev/pytest/issues/3223
     pytest3.3: pytest ~= 3.3.0
+    pytest3.3: pytest-xdist < 1.19.0
     pytest3.4: attrs < 19.2.0  # https://github.com/pytest-dev/pytest/issues/3223
     pytest3.4: pytest ~= 3.4.0
+    pytest3.4: pytest-xdist < 1.19.0
     pytest3.5: pytest ~= 3.5.0
+    pytest3.5: pytest-xdist < 1.19.0
     pytest3.6: pytest ~= 3.6.0
+    pytest3.6: pytest-xdist < 1.28.0
     pytest3.7: pytest ~= 3.7.0
+    pytest3.7: pytest-xdist < 1.28.0
     pytest3.8: pytest ~= 3.8.0
+    pytest3.8: pytest-xdist < 1.28.0
     pytest3.9: pytest ~= 3.9.0
+    pytest3.9: pytest-xdist < 1.28.0
     pytest3.10: pytest ~= 3.10.0
+    pytest3.10: pytest-xdist < 1.28.0
     pytest3.x: pytest ~= 3.0
+    pytest3.x: pytest-xdist < 1.28.0
     pytest4.0: attrs < 19.2.0  # https://github.com/pytest-dev/pytest/issues/5900
     pytest4.0: pytest ~= 4.0.0
+    pytest4.0: pytest-xdist < 1.28.0
     pytest4.1: attrs < 19.2.0  # https://github.com/pytest-dev/pytest/issues/5900
     pytest4.1: pytest ~= 4.1.0
+    pytest4.1: pytest-xdist < 1.28.0
     pytest4.2: attrs < 19.2.0  # https://github.com/pytest-dev/pytest/issues/5900
     pytest4.2: pytest ~= 4.2.0
+    pytest4.2: pytest-xdist < 1.28.0
     pytest4.3: pytest ~= 4.3.0
+    pytest4.3: pytest-xdist < 1.28.0
     pytest4.4: pytest ~= 4.4.0
+    pytest4.4: pytest-xdist ~= 1.0, < 1.30.0  # https://github.com/pytest-dev/pytest-xdist/issues/472
     pytest4.5: pytest ~= 4.5.0
+    pytest4.5: pytest-xdist ~= 1.0, < 1.30.0  # https://github.com/pytest-dev/pytest-xdist/issues/472
     pytest4.6: pytest ~= 4.6.0
+    pytest4.6: pytest-xdist ~= 1.0, < 1.30.0  # https://github.com/pytest-dev/pytest-xdist/issues/472
     pytest4.x: pytest ~= 4.0
+    pytest4.x: pytest-xdist ~= 1.0, < 1.30.0  # https://github.com/pytest-dev/pytest-xdist/issues/472
     pytest5.0: pytest ~= 5.0.0
+    pytest5.0: pytest-xdist ~= 1.0, < 1.30.0  # https://github.com/pytest-dev/pytest-xdist/issues/472
     pytest5.x: pytest ~= 5.0
+    pytest5.x: pytest-xdist ~= 1.0, < 1.30.0  # https://github.com/pytest-dev/pytest-xdist/issues/472
     mypy0.50: mypy >= 0.500, < 0.510
     mypy0.51: mypy >= 0.510, < 0.520
     mypy0.52: mypy >= 0.520, < 0.530
@@ -72,7 +96,7 @@ deps =
 
     pytest-cov ~= 2.5.1
     pytest-randomly ~= 2.1.1
-commands = py.test --cov pytest_mypy --cov-fail-under 100 --cov-report term-missing {posargs}
+commands = py.test -p no:mypy -n auto --cov pytest_mypy --cov-fail-under 100 --cov-report term-missing {posargs}
 
 [testenv:flake8]
 skip_install = true