Lyme disease was first reported in 1977, following an unusual cluster of adults and children with oligoarticular arthritis in a certain neighborhood of Lyme, Connecticut. Subsequently, a multisystem disease was described and attributed to the spirochete Borrelia burgdorferi. Lyme disease manifests as a spectrum of skin, musculoskeletal, cardiac, and neurologic findings. It is a vector-borne disease following the bite of an Ixodes tick—usually the black-legged Ixodes scapularis, commonly known as the deer tick. The species Ixodes includes additional subspecies (eg, I. pacificus, I. dammini, and I. ricinus) that contribute to a worldwide distribution of the disease and is known to be endemic in North and South America, Europe, Asia, Africa, and Australia. Prenatal exposure to B. burgdorferi and the development of gestational borreliosis can result in maternal Lyme disease with placentitis and transplacental infection of the fetus and newborn.