Scrub typhus caused by Orientia tsutsugamushi is a vector-borne, zoonotic disease which is common in the tsutsugamushi triangle. Scrub typhus causes AUFI in patients with non-specific clinical features and is difficult to diagnose when the highly characteristic but not pathognomonic eschar is not seen. As the eschar is not always present, laboratory tests are needed for confirmation. Serological assays are the main stay of laboratory diagnosis of scrub typhus thus far. In this review, we present the salient clinical features and clinical algorithms suggestive of this disease that help in better selection of diagnostics. The various scrub typhus assays along with their advantages and disadvantages have also been discussed. Furthermore, we have also discussed the upcoming diagnostics, both serological and molecular assays which can be available in the near future.