The epidemiology of neurosyphilis is presented in article. The pathogenetic mechanisms of involvement in the syphilitic process are described already in the early stages of the disease of the central and peripheral nervous system and, in particular, of the auditory and vestibular analyzers. Described classical clinical forms of neurosyphilis. Statistical data on the incidence of syphilis in Russia from the 20—30s of the last century to the present are given. Presented analysis of the development of the incidence rate in Russia of syphilis and neurosyphilis, the main methods for the diagnosis of neurosyphilis. The changes in the structure of neurosyphilis disease that have occurred over the past 20 years, which are characterized by nonspecificity, course wear and inversion of typical clinical symptoms, as a result of pathomorphism, are described. The article describes the mechanism for the development of the pathological process in the inner ear with syphilitic infection. Described changes in the capillary wall of the vascular streak, leading to impaired hematolabyrinth barrier function and the development of the labyrinth hydrops. Literature data on the electron microscopic study of the vascular strip of the rabbit webbed snail infected with syphilis are presented. The article also collected literature data on indicators obtained by audiological and vestibulological studies of the inner ear in cases of early and late neurosyphilis. The article focuses on the possible only manifestation of neurosyphilis in the form of cochleovestibular symptoms.