Tick-borne rickettsioses are endemic in Greece, however until recently only Rickettsia typhi and R. conorii were routinely tested in human samples arriving at the National Reference Centre. During the last years, the identification of different rickettsia species in ticks led to the introduction of other spotted fever group rickettsiae in the routine analysis. Under the new scheme, R. massiliae is now routinely tested in human samples, hence the description of the current human case.