SummaryEast Coast fever (ECF) is the most important tick-borne disease in eastern, central and southern Africa and caused an estimated loss of US $186 million in 1989 in the 11 countries where it occurs. It was brought to southern Africa with cattle from Tanzania in 1901 and, over the next 3 years, devastated the cattle that had survived the rinderpest pandemic of the 1890s. Chemical control of ticks using arsenical compounds was introduced in the early 1900s and became the main control measure for both ticks and the diseases they transmit. This method of control has become less reliable over the last 30 years for many reasons, including reduced government spending on livestock and extension, the cost of acaricides, acaricide resistance, poor management of dips and spray races, and poor application of cattle movement control and quarantine. Significant advances in immunization and treatment have been made in the last 30 years, and more robust integrated strategies combining immunization, reduced frequency of chemical control and treatment are being adopted or considered. Throughout its history, ECF has been a source of great anxiety and cost to farmers, and of intense interest to research workers. Many dogmas and misconceptions have become established, some of which still flourish while others took years to demolish. This paper briefly reviews these as well as the history of the disease and explores recent epidemiological findings and their relevance to applying effective control.