Weakly positive syphilis spirochete may be weakly positive for syphilis spirochete specific antibody (TPPA) or weakly positive for syphilis spirochete non-specific antibody (RPR). Weak positive syphilis spirochete, may be syphilis, may not be syphilis, need to be analyzed and judged according to the specific circumstances, it is recommended to review the test in one month. Syphilis is a chronic systemic sexually transmitted disease caused by syphilis spirochete infection. After infection with the spirochete, the body’s immune system will produce a variety of antibodies against the spirochete, which are mainly divided into two categories: one is specific syphilis antibody (TPPA); the other is non-specific syphilis antibody (RPR). The TPPA is weakly positive and the RPR is also weakly positive and remains weakly positive after retesting. Painless ulcers appear in the external genital area; or purplish-red or dark-red plaques or macules with painless blisters or ulcers forming on them appear in other parts of the body. Weakly positive syphilis spirochetes are usually a sign of syphilis. Weakly positive syphilis spirochete-specific antibodies (TPPA), negative syphilis spirochete non-specific antibodies (RPR), and the absence of high-risk syphilis exposure behaviors and the absence of clinical symptoms are generally not considered to be syphilis or only suggestive of previous syphilis infection. Negative Treponema pallidum specific antibodies (TPPA) and weakly positive Treponema pallidum non-specific antibodies (RPR) are usually not syphilis. A weakly positive syphilis spirochete is best determined by a comprehensive analysis of test results, exposure history, and clinical symptoms. Once the diagnosis of syphilis is confirmed, it is necessary to start early treatment with antimicrobial drugs to expel syphilis, such as injectable benzylpenicillin and injectable ceftriaxone sodium.