Tickborne rickettsial diseases (TBRD) are a set of distinct diseases with similar signs and symptoms that are transmitted to humans by tick bites. In the United States, these diseases include 1) Rocky Mountain spotted fever (RMSF), 2) ehrlichiosis, 3) anaplasmosis, and 4) emerging diseases such as Rickettsia parkeri infection. The reported incidence of these diseases has increased during the previous decade. The illnesses associated with these diseases can vary from mild symptoms treated at home, to severe infections requiring hospitalization for care, with the potential for death in rare cases. Although easily treated with the antibiotic doxycycline, these diseases can be difficult for physicians to appropriately suspect and diagnose. However, early recognition and treatment of infection is important to decrease the risk for serious outcome. Preventing exposure to ticks and tick habitat is important to prevent exposure to TBRD.