Patients who have had syphilis for 20 years are potentially curable, but pre-existing organic damage and complications are generally difficult to cure. Syphilis is a systemic chronic sexually transmitted disease caused by infection with the syphilis spirochete. Early syphilis patients can be cured with active treatment. Syphilis patients who have been ill for 20 years have generally developed into advanced syphilis, and if combined with organic damage and various complications, it is generally difficult to cure. Patients who have had syphilis for 20 years have had their body systems invaded by syphilis spirochetes, which may even cause irreversible damage to body organs, and in severe cases may even be life-threatening. Therefore, patients who have had syphilis for 20 years are more difficult to treat, and the possibility of cure is relatively small. Therefore, people infected with syphilis should start treatment as early as possible to prevent it from developing into advanced syphilis.