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During recent decades, a tick-borne rickettsial syndrome, characterized by eschar and painful lymphadenopathy after <i>Dermacentor marginatus</i>-bite, has been described as an emerging rickettsiosis in Europe. Our group named it DEBONEL (<i>Dermacentor</i>-borne-necrosis-erythema-lymphadenopathy), regarding the vector and the main infection signs. Other groups called it TIBOLA (tick-borne-lymphadenophathy) and, later, SENLAT (scalp-eschar-and-neck-lymphadenopathy-after-tick-bite), expanding, in the latter, the etiological spectrum to other pathogens. Objective: To investigate the etiology of DEBONEL agents in our area, and to compare their epidemiological/clinical/microbiological characteristics. During 2001–2020, 216 patients clinically diagnosed of DEBONEL (the largest series from one center) in La Rioja (northern Spain) were examined. <i>Rickettsia</i> spp. were amplified in 14/104 (13.46%) blood samples, 69/142 (48.59%) eschar swabs, 7/7 (100%) biopsies, and 71/71 (100%) <i>D. marginatus</i> from patients. For samples in which <i>Rickettsia</i> was undetected, no other microorganisms were found. ‘<i>Candidatus</i> Rickettsia rioja’, <i>Rickettsia slovaca</i>, <i>Rickettsia raoultii</i>, and <i>Rickettsia</i> DmS1 genotype were detected in 91, 66, 4, and 3 patients, respectively. DEBONEL should be considered in patients with clinical manifestations herein described in areas associated to <i>Dermacentor.</i> The most frequently involved agent in our environment is ‘<i>Ca.</i> R. rioja’. The finding of <i>Rickettsia</i> sp. DmS1 in ticks attached to DEBONEL patients suggests the implication of other rickettsia genotypes.