Background: Syphilis, which can be successfully controlled by public health measures however, in Brazil it is a major health problem. MOH recommends testing for syphilis and HTV during pregnancy and repeating syphilis test during admittance for delivery. Medical care in public sector is free of charge, therefore, antenatal care including syphilis and HIV diagnosis and treatment arc obtained at no charge. Congenital syphilis (CS) case report is required by health regulation, being reported nationwide in a standard form. Methods: All certificates of perinatal infant death occurring in year 2000 in state of Rio de Janeiro were analyzed for perinatal mortality due to CS. Additional information was obtained from the case report surveillance system. Results: 2,28%(89/3900) of stillbirth and 0,79%(20/2531) of perinatal infant mortality were attributed to CS. Only 7 of 91 cities informed death due CS. 94,2% of stillbirths (81/86) diagnosis were cstablished in one city. In some maternities ward, where testing the mother for syphilis is regularly performed CS was responsible for up to 15,3% off all stillbirth (20/124) and 6,4%(5/78) of perinatal death until 7 days old. 28,4%of the mothers were £ 18 y, 56 %(56/100) did not have antenatal care and 25% had four or more antenatal visits, 27,3%(12/44) of the mothers have syphilis diagnosis during prenatal care and 4,8%(1/21) tested positive for HIV. 14,3%(6/42) of the partners were treated. Conclusions: Burden of syphilis is still very high. Under repor is frequent. Actions taken to cope with syphilis control have failed. Future measures planed to tackle the problem are the adoption of a reward to cities that would be able to reduce CS impact.