Syphilis is a sexually transmitted disease [STD] with protean manifestations resulting from infection by Treponema pallidum. It can be easily treated with long acting penicillin. Syphilis promotes the transmission of HIV and both infections can simulate and interact with each other. Treponemes may persist despite effective treatment and may have a role in reactivation in immunosuppressed patients. A study was done to know the incidence of syphilis in the rural teaching hospital of Trichy district. Atotal of 4396 samples were collected from the patients during 2010 to 2013. Rapid Plasma Reagin [RPR] test was done. The incidence was found to be low [0.34%] and the maximum positivity was in the age group of 21-40 years. The incidence of syphilis at first prenatal visit was extremely low (0.31%). Partner notification, health education, and screening in high risk populations and pregnant women to prevent congenital syphilis are essential aspects in controlling the infection.