A 21-year-old female patient with acute labyrinthitis caused by intra-aural tick infestation was successfully treated using a multimodal approach, resulting in symptom resolution within 4 weeks. The case report highlights the potential complications of aural tick infestation, including tinnitus, hearing loss, vertigo, and facial nerve palsy. Early intervention and comprehensive patient care involving otolaryngologists, infectious disease specialists, and neurologists are crucial in preventing long-term complications. The authors also discussed the potential role of quantitative polymerase chain reaction (qPCR) testing for rickettsial infections, particularly in cases presenting with facial nerve palsy.