Lyme disease has been reported most often in the northeastern United States, but it has been reported in all 50 states, as well as China, Europe, Japan, Australia, and parts of the former Soviet Union. In the United States, it is primarily contracted in the Northeast from the states of Maine to Maryland, in the Midwest in Minnesota and Wisconsin, and in the West in Oregon and Northern California.
Borrelioosi on esinenud kõige sagedamini Kirde Ameerika Ühendriigid, kuid sellest on teatatud kõikide 50 Ühendriigid, samuti Hiina, Euroopa, Jaapan, Austraalia, ja nende osade endise Nõukogude Liidu. Ameerika Ühendriikides, see on eelkõige lepinguliste Kirde alates Ühendriikide Maine'i et Maryland, aastal Midwest Minnesota ja Wisconsin, ja Lääne Oregoni ja Põhja-California.