Significant impacts of global climate change on wildlife have been documented and are projected to continue. Reptiles have been suggested as being especially susceptible to these effects along with other anthropogenic impacts on their environment. A retrospective review of medical records for 2,356 wild eastern box turtles (Terrapene carolina carolina) admitted to the Turtle Rescue Team (TRT) at the North Carolina State University College of Veterinary Medicine between 1996 and 2017 was performed in order to: 1) report common presenting complaints, 2) describe the timeline of when box turtles were admitted to the TRT for each year of the study, and 3) investigate temporal shifts in turtle admissions and associations with changes in environmental temperature over a 22-yr period. The most common presenting complaint was vehicular trauma (n = 1,195) with over 70% of the caseload associated with anthropogenic impacts. Average monthly temperatures from 1996 to 2017 for Raleigh, North Carolina, USA, were extracted from the National Oceanic and Atmospheric Administration climate database. By comparing the pre- and post-2006 years using the Mann–Whitney test, we found that both the annual peak temperature and the annual timing of admission to the TRT have shifted significantly or with a strong tendency towards significance (P = 0.0008 and 0.052, respectively). Annual peak temperature has increased by 1.3°C, and timing of admission has shifted 18 days earlier between pre- and post-2006 years. This supports the hypothesis that box turtle activity patterns are shifting and that these changes are potentially related to climate.