Objective To analyze the characteristics of clinical manifestations of Lyme borreliosis cases. Methods Clinical data of 25 hospitalized patients with Lyme disease admitted to Beijing Friendship Hospital from January 2013 to April 2024 were collected, and clinical characteristics of patients were analyzed. Results The average age of 25 patients with confirmed Lyme disease was (48.60±17.89) years, 20 patients (80.0%) presented fever. 8 patients (32.0%) had joint pain, mainly in large joints such as knee joint, elbow joint, lumbar spine, and hip joint. 10 patients (40.0%) had skin lesions, including 2 cases of erythema migrans and 8 cases predominantly with maculopapular rash. Neurological manifestations were mainly numbness in the limbs, muscle twitching, and abnormal skin sensations (n=8, 32.0%), cardiovascular damage was mainly arrhythmias (n=3) and pericardial effusion (n=1). Disease course of 23 patients (92.0%) was <6 months, but were accompanied by multiple comorbidities. All patients tested positive for Lyme disease antibodies (IgM or IgG). Before the onset of the disease, 8 patients (32.0%) lived in Beijing, 7 (28.0%) lived abroad, and 10 (40.0%) lived in provinces other than Beijing. All patients had a history of mosquito bites, with 5 patients confirmed to have been bitten by ticks. Conclusion Lyme disease involves multiple organs, and patients have diverse clinical symptoms. Epidemiological history of tick bites and laboratory testing of related antibodies can improve the diagnosis rate of this disease.