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Background Congenital syphilis (CS) is a preventable condition. However, in 2017, 4,039 cases were reported in Sao Paulo State (SPS), with an incidence rate of 6.6 cases/1,000 live births (LB). In 2018, SPS proposed the “95-95-95” goals to reduce CS: 95% of all pregnant women (PW) with timely diagnosis during antenatal care (ANC), 95% of all with timely diagnosis receiving treatment and 95% of all babies from treated PW-syphilis, born without CS. This study aimed evaluates the pregnancy syphilis cascade of care and the “95-95-95” goals for reducing CS in SPS, 2017. Methods Ecological study, using reported cases of PW-syphilis and CS. The cascade of PW-syphilis care was estimated considering five columns. First column: number of PW-syphilis, calculated considering an estimated prevalence of 2.1% of syphilis in PW; and for the total population of PW, was considered the number of LB increased by 10% for fetal losses. Second: PW-syphilis diagnosed during ANC or delivery. Third: PW-syphilis linked to ANC with timely diagnosis. Fourth: PW-syphilis properly treated. Fifth: potentially avoided CS cases. Results Were estimated 14,369(100%) PW-syphilis, of these, 82.6% (N=11,875) were diagnosed during ANC or delivery; 73.8% (N=10,606) linked to ANC with timely diagnosis; 66.1% (N=9,500) treated and 54.5% (N=7,836) CS cases avoided. For the “95-95-95” goals, SPS reached the following levels: 89.3% (N=10,606/11,875) of PW-syphilis with diagnosis during ANC; 89.6% (N=9,500/10,606) were timely treated and 82.5% (N=7,836/9,500) of babies born without CS. Conclusion Prevention actions should be intensified to improve access and qualification of ANC. Specifically: wide screening coverage, availability of medication for the timely treatment and reproductive planning. These challenges can be overcome with an agenda of priorities and political commitment. The integration of STI/HIV/AIDS and maternal-child health programs, as well as the strengthening of primary care, is essential for the sustainability, duration and success of interventions aimed to the CS elimination. Disclosure No significant relationships.