Syphilis is a sexually transmitted disease (STD) caused by spirochete bacterium Treponema pallidum characterized by a long clinical course in which, over a period of more than ten years, alternate several stages: primary, secondary, early and late latent and tertiary syphilis. The purpose of this paper is to examine the incidence and clinical features of syphilis in patients diagnosed at the Clinical Hospital Center of Rijeka over the last decade with the aim of providing information on the current regional epidemiologic and clinical features of this STD. In the period from 2009 to 2018, 74 subjects were diagnosed with syphilis, out of which 58 males (78%) and 16 females (22%) with an average age of 38.23 years and median 34 years. For comparison, in the period from 1989 to 2008, there were 304 new cases of syphilis, out of which 186 men (61%) and 118 women (39%). Based on the epidemiological data available for 32 patients, 7 (22%) indicated a prior unprotected sexual intercourse, and 8 (25%) declared themselves as men who have sex with men (MSM). Clinically, 7 (11%) patients were detected in the primary stage, 24 (39%) in the secondary, 22 in latent (35%), and none in the tertiary stage. All patients who were available for follow-up, 34 (64%) of them, showed a satisfactory drop in control serological titers 3 months after treatment and their disease is considered cured. Conclusions are that the incidence of syphilis stagnates but has decreased compared to the previous 30 years. The most common occurrence is among the higher risk groups, especially the MSM.