Systemic control of syphilis in Russia began in the middle of the 19^th century with the creation of Medical and Police Committee for the Supervision of Prostitution and «On measures of medical police against concupiscent disease» circular. In 1897, the Medical Department of the Ministry of Internal Affairs of Russia held the world’s first congress on syphilis control, which laid the foundation for the state strategy on this issue. In the Urals, the first steps to combat sexually transmitted diseases were recorded as early as the 18^th century. In 1827, an isolated department for syphilis-infected patients was created at the Berezovsky plant. However, in the 19^th century treatment remained fragmentary: district councils and cities clashed over funding, and private clinics refused to provide free care. The situation improved after the opening of venereologic wards and publication of studies such as P.N. Serebrennikov’s work on «fair prostitution». In the Soviet era, the fight against sexually transmitted diseases took place at the state level: in the 1920s, mass organization of venereologic dispensaries and mobile units began in the USSR. In the 1960s, the network of dermatovenereologic institutions in the Sverdlovsk region included a regional dermatovenereologic dispensary, 7 branches, 117 offices and 704 beds. Despite the peak incidence in the post-war years, by 1966 congenital syphilis was almost eliminated in the region. The evolution of sexually transmitted disease control from reactive measures to systemic health infrastructure is considered. Creation of specialized institutions, integration of science and practice and health education were the key success factors. In the Urals, the implemented measures allowed to significantly reduce the incidence of syphilis by the middle of the 20^th century despite the historical difficulties.