Lyme disease (LD), a vector-borne disease, causes illness for many individuals in the United States. All of the conditions for the promulgation of LD are present in one Southern state in the United States; yet this state reports lower numbers of LD than adjacent states. The purpose of this study was to determine associations between this Southern state's primary care providers' knowledge and attitudes regarding the diagnosis and reporting of LD. A quantitative, cross-sectional study was conducted via a mailed questionnaire by the Arkansas Department of Health to 2,693 primary care providers. Respondents were 660 primary care providers from all regions of this state. Secondary data were analyzed using descriptive, Chi square, and logistic regression techniques. Analysis results included the following: a correct response rate of 59.1 % for symptom recognition, of 46.2 % for knowledge of recommended testing processes, and of 78.9 % for knowing LD is a reportable disease. These results compared to the expected norm were significant in every area with p values of .000. Specialty, region, and years of practice were found to be confounding influences in a number of assessment areas.