Rickettsioses can present with protean manifestations. Recent progress in molecular biology allows a better classification of the array of pathogens involved. Rickettsial tick-borne diseases are of emerging importance given nowadays increased in international travellers. Because of substantial morbidity and mortality associated with a delay in diagnosing and treating these infections, awareness of both their geographical distribution and their clinical presentations is important, and the empirical administration of appropriate antibiotic is often justified. Travellers to endemic areas should be encouraged to use personal protective measures.