Pseudotuberculosis in humans until the 1950s was found in different countries of the world as a rare sporadic disease that occurred in the form of acute appendicitis and mesenteric lymphadenitis. In Russia and Japan, the Yersinia pseudotuberculosis (Y. pseudotuberculosis) infection often causes outbreaks of the disease with serious systemic inflammatory symptoms, and this variant of the disease has been known since 1959 as Far Eastern Scarlet-like Fever (FESLF). Russian researchers have proven that the FESLF pathogen is associated with a concrete clonal line of Y. pseudotuberculosis, characterized by a specific plasmid profile (pVM82, pYV 48 MDa), sequence (2ST) and yadA gene allele (1st allele). This review summarized the most important achievements in the study of FESLF since its discovery in the Far East. It has been established that the FESLF causative agent is characterized by a unique phenomenon of psychrophilicity, which consists of its ability to reproduce in the environment with its biologically low and variable temperature (4–12 °C), at which the pathogen multiplies and accumulates while maintaining or increasing its virulence, which ensures the emergence and development of the epidemic process. The key genetic and biochemical mechanisms of Y. pseudotuberculosis adaptation to changing environmental conditions were characterized, and the morphological manifestations of the adaptive variability of these bacteria in different conditions of their habitat were revealed. The main features of the pathogenesis and morphogenesis of FESLF, including those associated with the Y. pseudotuberculosis toxigenicity, were presented. The pathogenetic value of the plasmid PVM82, found only in the FESLF pathogen, was shown.