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The modern epidemiological picture of syphilis is such that the detection of syphilitic mesaortitis, as a manifestation of cardiovascular pathology in tertiary syphilis, represents only 10% of cases. One of the most frequent and serious complications of mesaortitis is an aortic aneurysm. The nonspecific nature of symptoms and clinical course of such aneurysms sometimes complicates the timely detection of this pathology, that leads to high mortality at the hospital stage. This article describes a rare case of syphilitic mesaortitis complicated by aortic aneurysm.