The performance of ELISAs with the recombinant antigens decorin-binding protein A (DbpA), DbpB, and BBK32 (from Borrelia afzelii, B. garinii, and B. burgdorferi sensu stricto) and VlsE peptide antigen invariable region 6 (IR(6)) were evaluated in the serodiagnosis and follow-up of children with Lyme arthritis (LA). Serum samples were obtained from 52 children with clinically typical and serologically confirmed LA. In IgG ELISAs, at diagnosis, 50 samples were positive for BBK32, 51 for DbpA, 40 for DbpB, and 51 for IR(6). In the posttreatment follow-up, the rate of decline of the antibodies to the recombinant protein antigens or to IR(6) did not appear useful in the prediction of the treatment response or the clinical course of LA. Yet, IR(6) seems to have the greatest potential to be used universally in the diagnostic serology of Lyme borreliosis (LB). Alternate to that, the use of several specific borrelial antigens, in parallel, might improve the accuracy of serology for LB.