Rickettsia is an obligate intracellular parasitic bacterium which has been included in the list of biowarfare agents. Rickettsial diseases are zoonotic, natural focal diseases, and also threats to human health seriously. Different from the standard detection methods for other bacteria, the diagnosis of rickettsial diseases needs a collective consideration of the epidemiological data, clinical symptoms and laboratory test results. Although Rickettsia detection technology has been developed for more than 100 years, early rapid diagnosis is still difficult. Current progresses on Rickettsia and rickettsial disease detection, including pathogen isolation and molecular detections, are reviewed in this paper.