The most common vector-borne diseases in both Europe and North America are transmitted by ticks. Lyme borreliosis (LB), a tick-borne bacterial zoonosis, is the most highly prevalent. Other important tick-borne diseases include TBE (tick-borne encephalitis) and Crimean-Congo haemorrhagic fever in Europe, Rocky Mountain spotted fever (RMSF) in North America, and numerous less common tick-borne bacterial, viral, and protozoan diseases on both continents. The major etiological agent of LB is Borrelia burgdorferi in North America, while in Europe several related species of Borrelia can also cause human illness. These Borrelia genospecies differ in clinical manifestations, ecology (for example, some have primarily avian and others primarily mammalian reservoirs), and transmission cycles, so the epizootiology of LB is more complex in Europe than in North America. Ticks dwell predominantly in woodlands and meadows, and in association with animal hosts, with only limited colonization of human dwellings by a few species. Therefore, suburbanization has contributed substantially to the increase in tick-borne disease transmission in North America by fostering increased exposure of humans to tick habitat. The current trend toward suburbanization in Europe could potentially result in similar increases in transmission of tick-borne diseases. Incidence of tick-borne diseases can be lowered by active public education campaigns, targeted at the times and places of greatest potential for encounter between humans and infected ticks. Similarly, vaccines (e.g., against TBE) are most effective when made available to people at greatest risk, and for high-prevalence diseases such as LB. Consultation with vector-borne disease experts during the planning stages of new human developments can minimize the potential for residents to encounter infected ticks (e.g., by appropriate dwelling and landscape design). Furthermore, research on tick vectors, pathogens, transmission ecology, and on geographic distribution, spread, and management of tick-borne diseases can lead to innovative and improved methods to lower the incidence of these diseases. Surveillance programs to monitor the distribution and spread of ticks, associated pathogens, and their reservoirs, can allow better-targeted management efforts, and provide data to assess effectiveness and to improve management programs.