Tick-borne disease is rare in the neonatal population, but an index of suspicion must exist for those infants that present with these unusual illnesses, such that appropriate treatment can be initiated as soon as possible. Obtaining a thorough clinical history from the parents of a child is of vital importance when assessing for a potential infection. Questions should include any known tick exposure (although the absence of a known tick bite should not preclude treatment); contact with animals including domestic pets, similar illness in a family member, or other close contact; and length of symptoms. Babesiosis, the most common tick-borne infection among neonates, may be transmitted via transfusion of infected blood products.