Agents that cause Lyme disease, relapsing fever, leptospirosis, and syphilis belong to the phylum Spirochaetae-a unique lineage of bacteria most known for their long, spiral morphology. Despite the relevance to human health, little is known about the most fundamental aspects of spirochete growth. Here, using quantitative microscopy to track peptidoglycan cell-wall synthesis, we found that the Lyme disease spirochete Borrelia burgdorferi displays a complex pattern of growth. B. burgdorferi elongates from discrete zones that are both spatially and temporally regulated. In addition, some peptidoglycan incorporation occurs along the cell body, with the notable exception of a large region at the poles. Newborn cells inherit a highly active zone of peptidoglycan synthesis at midcell that contributes to elongation for most of the cell cycle. Concomitant with the initiation of nucleoid separation and cell constriction, second and third zones of elongation are established at the 1/4 and 3/4 cellular positions, marking future sites of division for the subsequent generation. Positioning of elongation zones along the cell is robust to cell length variations and is relatively precise over long distances (>30 μm), suggesting that cells "sense" relative, as opposed to absolute, cell length to establish zones of peptidoglycan synthesis. The transition from one to three zones of peptidoglycan growth during the cell cycle is also observed in relapsing fever Borrelia. However, this mode of growth does not extend to representative species from other spirochetal genera, suggesting that this distinctive growth mode represents an evolutionary divide in the spirochete phylum.L yme disease is a multisystem disorder that results in flu-like symptoms and, if left untreated, can develop into arthritis, carditis, and severe neurological complications. In recent years, the incidence and geographical range of Lyme disease have rapidly risen (1, 2), making it the most reported vector-borne disease in the United States. In North America, the primary causative agent of Lyme disease is the spirochetal bacterium Borrelia burgdorferi sensu stricto. Whereas most research efforts have focused on host invasion, immune response, and the gene regulatory mechanisms involved in pathogen transmission, comparatively little attention has been paid to the basic biology of this important pathogen (3). In particular, how this bacterium grows and divides remains unknown, despite the fact that these processes are essential for its proliferation. Our knowledge gap in the principles fundamental to cell growth and division extends to the entire spirochete phylum, which, besides B. burgdorferi, includes many important disease-causing agents, such as those responsible for syphilis, relapsing fever, and leptospirosis (4).Spirochetes are unusual bacteria in many respects. For example, most spirochetes are very thin (∼0.2 μm) and long (up to 150 μm) and have a spiral or undulated morphology. Despite similar morphological features, the phylum displays extensive niche dive...