This paper describes the epidemiological, clinical and laboratory features of 76 cases of Mediterranean spotted fever occurring during the years 1977-1986. The patients observed all lived in the Lombardy region of Italy, which is not located on the Mediterranean Basin. Our data show the highest prevalence of the disease, as reported by other authors, in southern regions of Italy, in the same years: 1979-1983. No differences were noted between age groups or sexes, and the late spring-summer seasonality was confirmed. The clinical signs and symptoms in our cases were those common to the disease. The microimmunofluorescence method was found to be more sensitive and specific than the Weil-Felix test for serological diagnosis. Finally, we showed that doxycycline and oxytetracycline both induce rapid remission of fever.