Tick infestation in humans is a major public health concern. The diversity and distribution of tick species associated with human otoacariasis was studied in five districts: Anuradhapura, Kandy, Kurunegala, Nuwara Eliya and Ratnapura in the main agro-climatic zones of Sri Lanka. Ticks from patients attending the ear, nose and throat clinics of the General Hospitals were collected during a 3year period. In total 426 ticks were collected. Most human otoacariasis cases were reported from Kandy (33.8%) and the fewest from Nuwara Eliya (8.2%). Of the five tick species identified, nymphs of Dermacentor auratus constituted 90.6% of the collection. Rhipicephalus sanguineus, Hyalomma isaaci, Haemaphysalis bispinosa and Otobius megnini were found rarely infesting humans possibly as an accidental host; H. bispinosa and O. megnini in the human ear canal were first time records in Sri Lanka. Females and children under 10years were identified as risk groups of human otoacariasis. Subsequently, a field study was carried out to determine socio-ecological risk factors of human tick infestations in the five districts. Based on hospital data, eight villages with high prevalence of otoacariasis were selected from each district. A total 40 villages were visited and 1674 household members were interviewed. Involvement in outdoor activities, presence of wild animals around the house, location of the house in close proximity to a forest and occupation were identified as major risk factors.