Background We conducted a retrospective study based on patients’ records of the Sexually Transmitted Infections Unit of “A. Sygros” Hospital in Athens, Greece. This is a tertiary referral centre for sexually transmitted infections from an area that has almost half the population of Greece.

Methods We focused on Primary Syphilis (PS), having confirmed the diagnosis both clinically and serologically. We documented the total annual number of patients, the male/female ratio, and the patients’ ethnic origin and sexual orientation.

Results We reviewed 1184 patients over the last eight years. The total number of patients with PS has risen from 111 in 2005 to 157 in 2012, an increase of 41.44%. The mean annual number is 144. The mean male/female ratio is 4.85, with a peak value of 8.50 in 2011. The majority of patients are of Greek origin, ranging from 67.4% to 87.2%. Within the male patients group, it seems that the percentage of homosexuals has risen steadily from 2005 (20.7%) up to 2011 (59.0%) with a decline in 2012 (46.0%). The mean value over eight years is 45.03%.

Conclusion PS in Greece is on the rise. This is probably related to moving populations because of immigration and sex trade. Changes in sexual behaviour can also be a factor. However, the majority of patients are Greek, despite immigrant influx. Men are the most numerous subgroup among PS patients, representing more than 80% of the total number of patients. Furthermore, there seems to be a trend towards predominance of homosexual men as the core group among male patients.