The Australian Gonococcal Surveillance Programme monitors antibiotic susceptibility testing of Neisseria gonorrhoeae isolated in all states and territories. In 2010 the in vitro susceptibility of 3,997 isolates of gonococci from public and private sector sources was determined by standardised methods. Varying antibiotic susceptibility patterns were again reported across jurisdictions and regions. Resistance to the penicillins nationally was 29% and, with the exception of the Northern Territory, ranged from 22% in Queensland to 42% in Victoria. Quinolone resistance, most at high minimal inhibitory concentration (MIC) levels, was 35% nationally (excepting the Northern Territory), ranging from 28% in Queensland to 44% in Victoria. Decreased susceptibility to ceftriaxone (MIC 0.06 mg/L or more), was found nationally in 4.8% of isolates. There has not been an isolate of N. gonorrhoeae with an MIC value greater than 0.125 mg/L reported in Australia. Nationally, all isolates remained sensitive to spectinomycin. Azithromycin surveillance was performed in New South Wales, Queensland, Western Australia, the Northern Territory and South Australia, and resistance was found in low numbers of gonococci with MIC values up to 16 mg/L. In larger urban centres the ratio of male to female cases was high, and rectal and pharyngeal isolates were common in men. In other centres, and in rural Australia, the male to female ratio of cases was lower, and most isolates were from the genital tract.