Introduction: Scrub typhus a neglected zoonoses and taken as differential diagnosis only after ruling out other causes of fever has now re-emerged and its prevalence also started to rise. This study is to show the prevalence of Scrub typhus in Northeast and its atypical presentation. Materials and Methods: The study included all cases of fever which were undiagnosed in the district level and tertiary hospital like Gauhati Medical College and Hospital from whom serum sample was taken and detection of IgM for scrub typhus was done by using In Bios International TM IgM ELISA. Results: Out of 148 cases, 33 were found to be positive, among the positive cases the number of males were more than females. The highest number of case was from Sonitpur district and patients mostly belong to age group 25-36 yrs. Conclusion: Thus scrub typhus can no longer be neglected but it should be included in routine differential diagnosis of fever even when there is no typical history or clinical presentation.