Scrub typhus is a potentially fatal infectious disease caused by Orientia tsutsugamushi. We report on a retrospective analysis of clinical manifestations, lab investigations and outcome of patients admitted to our hospital from January 2009 to December 2009 with scrub typhus. The Weil-Felix test was the serological method used to diagnose scrub typhus. A total of 29 patients were diagnosed with scrub typhus and the majority of them presented with fever (100%), headache (51%), myalgia (51%) and gastrointestinal symptoms (44%) as predominant features. Six patients (20%) presented with altered sensorium and signs of meningial irritation. There is an emergence of rickettsial infection in southern India, posing diagnostic difficulty and delay in treatment. Early diagnosis and treatment are important as it prevents serious complications associated with the disease.