The review presents the literature and statistical data on the prevalence of syphilis in European countries, the USA, Russia, and Moscow. It is noted that the current epidemiological situation with syphilis incidence in many developed countries continues to be unstable because of the wide spread of unconventional forms of sexual relations and migration. It is emphasized that hidden forms that are difficult to identify predominate among early epidemiologically dangerous forms of syphilis in Russia. In the capital of Russia, Moscow megalopolis, a persistent trend towards reduced incidence in all forms of syphilis had been observed from 2003 to 2012; however, an increase in the incidence rate by 10.3% was revealed in 2013 compared to the previous year. A substantial growth of late forms of neurosyphilis was noted (10 times in 2013 compared to 2003 and 2 times since 2012) that necessitates intensification of the epidemiological surveillance and wide practical application of modern highly sensitive and specific research methods for diagnosis of syphilis.