Tick-borne encephalitis (TBE) is caused by a neurotropic flavivirus, transmitted by the bite of Ixodes species tick vectors, and is increasing in incidence and expanding its geographical range throughout Eurasia and the Far East. Most infections are asymptomatic. However, between 2 and 30 % of cases may develop into severe neurological disease, long-term neurological sequelae or death. Diagnosis is based upon clinical signs of neurological disease and demonstration of virus-specific IgM and IgG antibodies. There is no specific antiviral treatment and supportive care is required for the various manifestations of disease. Vaccination is an effective way of preventing disease.