Background: Tick-borne viruses (TBVs) are a growing global health concern due to their severe impact on human and animal health and their expanding geographic distribution. Notable TBVs include Tick-Borne Encephalitis Virus (TBEV), Crimean-Congo Haemorrhagic Fever Virus (CCHFV), Heartland Virus (HRTV), and Powassan Virus (POWV). Objectives: This systematic review aims to evaluate the geographic distribution of TBVs, analyze their clinical impact, identify diagnostic challenges, review treatment options, and highlight research gaps. Methods: We conducted a comprehensive search across PubMed, Scopus, and Web of Science using keywords related to TBVs. Studies from 2000 to 2023 were selected based on criteria including peer-reviewed status and relevance to clinical, epidemiological, and treatment aspects of TBVs. Data were extracted on virus distribution, clinical manifestations, diagnostic methods, and treatment options, and synthesized qualitatively. Results: TBVs exhibit diverse geographic distributions, with notable expansions due to climate change and shifting tick populations. TBEV is expanding into new regions in Europe and Asia, CCHFV is spreading into the Balkans and Caucasus, HRTV is increasing in the U.S., and POWV is emerging in new areas of North America. Clinically, TBVs cause a range of symptoms from mild fever to severe neurological and haemorrhagic conditions. Diagnostic challenges include variability in test accuracy and availability, while treatment options remain limited, with few effective vaccines. Key research gaps include the need for improved diagnostic tools and vaccine development. Conclusions: TBVs present significant health risks with varying clinical outcomes and diagnostic difficulties. Enhanced surveillance, research, and public health interventions are critical to address the expanding geographic range and impact of these viruses.