A nationwide survey among all 118 Dutch rheumatologists (response rate 85%) yielded 42 patients with Lyme arthritis. The arthritis was nonpersistent in all these patients. A tick bite was reported by 23 of these 42 patients (55%). Erythema migrans was recalled by 19 patients (45%). Cardiac manifestations occurred in 4 patients (9%) and neurologic symptoms in 14 patients (33%). By immunoabsorbent assay or immunofluorescence technique 37 patients (88%) had positive IgG antibodies to Borrelia burgdorferi. The distribution of HLA-DR alleles of 28 of these patients was not different from the healthy population. The response to antibiotic treatment was considered good in 34 patients (81%). The clinical features of the Dutch patients with Lyme arthritis closely resemble the description of the disease reported from the United States.