• Although the incidence of Mediterranean spotted fever has increased dramatically in parts of Europe, Africa, and Asia, the disease is only rarely seen in travelers. We describe two children who had traveled in southern France and subsequently had rash and lymphadenopathy develop. Both children were treated with doxycycline and had unequivocal serologic evidence of Mediterranean spotted fever develop. Although this disease is usually mild, in the absence of a tick bite the disease can easily be confused with other febrile exanthems. We describe these patients to reemphasize the influence that international travel has brought to pediatrics.