AIM:To determine the prevalence of TBEV infection among patients with neurological acute and sub-acute disorders living in Saint-Etienne and its area, Auvergne-Rhône-Alpes, France. METHODS:This retrospective study includes patients aged over 2 years old presenting neurological acute and sub-acute disorders from 2021 January 1st to 2023 December 31st, living in Saint-Etienne and its area and for whom residual CSF specimen was stored at -80°C. When available, and if CSF specimen were either positive or in not enough quantity to be analyzed, serum specimens were tested. Clinical specimens were analysed for TBEV antibodies using ELISA Virion/Serion IgG and IgM kits (Eurobio, France). The local ethic committee approved this study. RESULTS:During this 3-year period, 544 patients were included. They were 7 cases (1.3 %) of confirmed TBEV infections including one child; 4 other possible cases with positive IgM CSF specimens and 12 patients presenting with IgG only, are still under investigation with seroneutralization due to potential cross-reactions. All the confirmed cases lived in rural areas, 5 presented with meningoencephalitis, one with meningoencephalomyelitis and one with meningitis. One patient had not been previously diagnosed for TBE. None died, and 3 were briefly hospitalised in Intensive Care Unit. CONCLUSIONS:In Saint-Etienne area, TBEV infection should be systematically evocated in case of neurological evocative symptoms, even in children. Vaccination may be discussed for people living in specific rural areas at risk. SOURCES OF FUNDING:Pfizer financially supported the purchase of ELISA kits without interfering in the design of the study nor the data interpretation.