The one tick-borne disease that rarely comes under the auspices of the infectious disease specialist is not caused by an infectious agent, but is tick paralysis. This condition is caused by tick bite and typically presents as a flaccid ascending paralysis. This article discusses this entity partly because of completeness, but also because tick paralysis, or tick toxicosis as it is sometimes called, is worth the infectious disease consultant's consideration. The differential diagnosis includes entities that are infectious or caused by toxins of infectious agents, such as epidural abscess, some causes of transverse myelitis, and botulism. Lastly, in an era of antibiotic toxicity, multidrug-resistant bacteria, antigen-switching viruses, and complex antibiotic regimens, the cure for tick paralysis-removing the tick-is as simple as it is gratifying.