Over the past four decades, Lyme disease has remained a virulent and pervasive illness, persisting throughout North America and many other regions of the world. Recent increases in illness in many countries has sparked a renewed interest in improved Lyme diagnostics. While current standards of diagnosis are acceptable for the late stages of the disease, it remains difficult to accurately diagnose early forms of the illness. In addition, current diagnostic methods tend to be relatively expensive and require a large degree of laboratory-based analysis. Biosensors represent the fusion of biological materials with chemical techniques to provide simple, inexpensive alternatives to traditional diagnostic methods. Lyme disease biosensors have the potential to better diagnose early stages of the illness and provide possible patients with an inexpensive, commercially available test. This review examines the current state of Lyme disease biosensing, with a focus on previous biosensor development and essential future considerations.