Despite the dramatic rise in syphilis incidence in the United States, studies on recently acquired syphilis in persons more than 60 years of age remain rare. Thirty-five cases of primary, secondary, and early latent syphilis in individuals 60 years and older were identified in the city of Hartford, Conn, between 1985 and 1990. There were no cases of early syphilis in the elderly reported from 1985 to 1986, whereas there were 23 cases reported from 1989 to 1990. Thirty-three cases occurred in men and two cases occurred in women; 25 patients were black, five were white, and five were Hispanic. Ten men reported having more than one sexual partner within 2 months of their diagnosis; five of these 10 had sexual relations with a prostitute. Physicians who care for the elderly should perform a complete sexual history and counsel patients regarding high-risk sexual practices. ( Arch Intern Med . 1992;152:330-332)