Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi and is transmitted to humans by a vector of the Trombiculidae family. An estimated one million new infections of typhus scrub occur every year, and more than one billion people around the world are at risk. The disease most commonly distributed in the Asia Pacific regions including Malaysia. Scrub typhus has been a neglected infectious disease for a long time hence many aspects of the disease including the diagnosis are still uncertain. It affects people of every age, including children. Humans are accidental hosts of the zoonotic disease. Patients with scrub typhus often develop non-specific symptoms that may mimic other zoonotic diseases. The clinical similarities between scrub typhus and other zoonotic diseases, the absence of pathognomonic eschars in some patients and the absence of diagnostic tests in some health care facilities pose a major challenge for the clinician. Effective and appropriate care should be initiated in a timely manner, as delay in treatment of scrub typhus can result in serious multiorgan failure with a case-fatality rate of up to 70%.