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Treponema pallidum, the causative agent of syphilis, is highly transmissible yet certain behaviours put individuals at higher risk of acquisition, including condomless sex, multiple sexual partnerships, and substance use associated with risky sex. Although syphilis is easy to diagnose and treat, infection rates continue to increase in high-income countries, particularly among men-who-have-sex-with-men (MSM), whilst they remain at endemic levels in low- and middle-income countries. Age-standardized syphilis incidence data from the Global Burden of Disease Study 2019 indicate an estimated annual percentage change of 0.16 (95%CI 0.06-0.26) from 1990 to 2019, with greatest increases observed in high sociodemographic regions and the Caribbean. A recent systematic review and meta-analysis of syphilis in MSM (2000-2020) reported a pooled global prevalence of 7·5% (95%CI:7·0-8·0%), ranging from 1·9% (95%:1·0-3·1%) in Australia/New Zealand to 10·6% (95%CI:8·5-12·9%) in Latin America and the Caribbean. Heterosexual transmission of syphilis pre-dominates in other parts of the world (for example, China and Japan). Temporal increases in syphilis among pregnant women have been reported in many countries, exemplified by Brazil and the USA, and this has been mirrored by rising incidence of congenital syphilis. In contrast, the prevalence of syphilis among pregnant women in most parts of the sub-Saharan Africa region seems to have decreased over the past 20 years, which may reflect prolonged efforts to strengthen antenatal syphilis screening on the African continent. Dual elimination of mother-to-child transmission of syphilis and HIV has been achieved in few countries. As syphilis infections increase the risk for both acquisition and transmission of HIV, rising rates of syphilis among MSM are of particular concern. Ultimately, syphilis prevention and control will require substantial financial investment, community education initiatives, a high index of suspicion among clinicians, rapid access to testing in de-stigmatised settings, timely and relevant surveillance-informed interventions, and efforts to address social determinants of health.