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Published Online:https://doi.org/10.1176/appi.ps.55.7.830

Along with the advent of the human immunodeficiency virus (HIV) came a worldwide resurgence of syphilis. The later stages of syphilis, especially neurosyphilis, may present with symptoms of virtually any psychiatric disorder. The authors present three cases of neurosyphilis diagnosed at the Center for Psychiatric Medicine of the University of Alabama at Birmingham, where the patients presented with overwhelmingly psychiatric manifestations. The authors recommend that clinicians have a high index of suspicion of neurosyphilis, which may have an exclusively psychiatric presentation.