Tick-borne illnesses (TBI) are infections acquired through a bite of a tick. Because of the nonspecific signs and symptoms experienced by patients presenting with TBIs, a high index of suspicion is crucial to include a TBI in the differential diagnosis of patients presenting with symptoms compatible with a TBI. Although the results of diagnostic testing are often not available at the time treatment decisions are made, it is important to obtain a history of possible tick exposure and consider the epidemiology of infected ticks when considering the possibility of TBI.