Syphilis has a variety of clinical manifestations and is known as a master of mimicry, which can be easily missed or misdiagnosed clinically, ranging from skin and mucous membrane manifestations to cardiovascular and neurological damage. There are also some patients who do not have any clinical manifestations but have a positive serological test, which is called occult syphilis. According to the stage of infection, those with less than two years of disease are early syphilis and those with more than two years are advanced syphilis. Early syphilis is divided into stage I and stage II syphilis in patients with symptoms. The prominent symptoms of stage I syphilis are hard chancre and syphilitic transcutaneous flaccid. The hard chancre refers to the inflammatory reaction at the site of spirochete invasion, manifested as erythema, erosion or shallow ulcers, usually solitary, lacking conscious symptoms, and easily detected in the genital area in men, but often difficult to detect in the vagina or cervix in women. Syphilitic cross-craft refers to the enlarged lymph nodes near the hard chancre, which are not purulent, hard and long-lasting. The second stage of syphilis occurs 6 to 12 weeks after the appearance of the hard chancre and is mainly found in the skin and mucous membranes, and occasionally invades the bones and nerves. Some patients often have systemic symptoms before the onset of the rash, such as headache, low-grade fever, general malaise, joint pain, loss of appetite, and swollen tonsils. Stage II syphilis rash has a variety of manifestations and can mimic the damage of various skin diseases, lack of conscious symptoms, and can subside on its own without treatment, so it is easy to be misdiagnosed clinically. Stage III syphilis can appear skin and mucous membrane manifestations, but also can invade the cardiovascular and nervous system. In recent years, due to the widespread use of antibiotics, the typical skin and mucous membrane manifestations of stage III syphilis have become very rare. Cardiovascular syphilis can appear as syphilitic aortitis, aortic valve atresia, aortic aneurysm, syphilitic coronary arteritis, myocarditis, etc. Neurological syphilis can cause spinal consumption and generalized paralytic dementia, as well as cerebrovascular accidents and meningitis.