Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, and is characterized by an eschar, lymphadenopathy, multisystem involvement and a rapid response to doxycycline. Scrub typhus is seen in all terrains of the tsutsugamushi triangle, a geographical region of south and east Asia and the southwest Pacific and is related mostly to agricultural activities [1]. Although it was known in China in the 3rd century A.D, scrub typhus (tsutsugamushi fever) was described by Hakuju Hashimoto in 1810 in people living on the banks of the Shinano river [2] and later by Baelz and Kawakami in 1879 [3] as Japanese “flood fever” [4]. Tsutsugamushi describes a Japanese term for tsutsuga “illness” and mushi “insect/creature”. Taiwan is the centre of the tsutsugamushi triangle and the first case reported in that country was in 1915 [5]. The first and second cases in Korea were reported in 1951 and 1986 respectively [6] and it now has the highest reported incidence in the world [7]. About one million new cases are identified annually [8]. The first reported cases in India were in 1934, in Himachal Pradesh [4]. We do not have definite statistics in India due to lack of awareness, unavailability and high cost of diagnostic kits and the fact that it is not a reportable illness.