As early syphilis becomes more uncommon in the community, it will present frequently to the tertiary hospital as a diagnostic problem. Twenty patients with classic signs and symptoms of primary and secondary syphilis in whom the correct diagnosis was initially missed are presented. The importance of a routine admission Venereal Disease Research Laboratory test (VDRL) in making the correct diagnosis is emphasized. The laboratory techniques for diagnosing syphilis and recommended treatment schedules are presented. Clinical manifestations of herpes progenitalis, problems with pregnancy and association with cervical carcinoma are also presented. Enteric diseases (hepatitis, shigellosis, giardiasis and amebiasis) as sexually transmitted diseases in homosexual men are summarized.