Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. A major public health issue in developing countries, the condition develops over four stages and is potentially fatal if untreated. A pregnant woman with syphilis can transmit the infection to her baby, which may result in a severe condition in liveborn infants, stillbirth, or neonatal death. Syphilis infection can be transmitted by direct person-to-person contact via open sores on the lips, mouth, genitals and other areas, and during vaginal, anal or oral sexual intercourse. Open sores also increase the risk of human immunodeficiency virus (HIV) infection. Universal syphilis screening within an existing antenatal care program has been advocated as an effective way to reduce syphilis-associated adverse outcomes. However, despite decades of syphilis-testing programs and substantial advances in screening technology, successful prevention and treatment of syphilis have been limited. This is largely due to delays in the identification and treatment of infected women. Technical and logistical difficulties with testing, lack of antenatal care, and poor-quality services are possible contributing factors. It is therefore crucial to investigate available randomised controlled trials to determine which test strategies are most effective in developing countries.