The disease melioidosis, caused by the bacterium Burkholderia pseudomallei, remains an important and sometimes neglected cause of disease in tropical regions of Australia. Infection may present in myriad ways, and diagnosis often requires consideration of this organism prior to culture. Laboratory identification of B. pseudomallei requires specialised testing beyond that available in many routine diagnostic microbiology laboratories. For this reason, cases outside of the traditional endemic zone, often occurring years after initial exposure to the organism, may remain undiagnosed or are delayed in diagnosis. Furthermore, the high levels of intrinsic antimicrobial resistance associated with B. pseudomallei often render empirical therapies ineffective. Health professionals, particularly those in rural and remote areas of Australia, must consider melioidosis in their differential diagnoses and remain abreast of advances in the field of this important emerging disease.