OBJECTIVE: This article presents an overview of Lyme disease (LD) as it applies to neuropsychiatry and summarises research results on the epidemiology of LD in South Africa. METHOD: The study is based on a review of research papers from various medical disciplines that focused on the epidemiology of LD in South Africa. RESULTS: Assessment of the incidence of LD in South Africa is based on a few anecdotal studies. The results of the studies are dominated by experimental weeknesses. CONCLUSIONS: The sporadic nature of LD Incidence in South Africa may either reflect a restriction of research efforts or be a true indication of the epidemiology of the disease. This review lends support to the former hypothesis. The low reported incidence of LD in South Africa is probably due to a lack of awareness and research effort.