Nine cases of congenital syphilis were reported. Transmission of syphilis from mother to child can cause multiple organ damage to the fetus, and sometimes it is difficult to diagnose neonatal sepsis, especially when the history of the mother is unclear, making it easier to miss the diagnosis. One case in this group of patients was delivered at home by a birth attendant; the amniotic fluid contained meconium samples and had an unusual smell upon admission. There was also purulent discharge from the umbilicus, leading to consideration of only neonatal sepsis. However, through syphilis serology and blood cultures, combined with clinical symptoms, the diagnosis was made of congenital syphilis along with Staphylococcus epidermidis sepsis. After early and regular treatment, the patient recovered. Penicillin remains the best drug for treating syphilis, emphasizing early, adequate, and full-course treatment. However, the dose should not be too large to avoid adverse reactions caused by the release of variant proteins from a large number of killed spirochetes. For children allergic to penicillin, the current application of ceftriaxone or azithromycin shows more satisfactory therapeutic effects [2,3]. Prevention and treatment of neonatal syphilis have become important topics. It is necessary to strengthen pre-marital medical examinations and delay marriage until syphilis is cured. Prenatal care should include rapid plasma reagin (RPR) screening tests, Treponema pallidum hemagglutination test (TPHA), or fluorescent treponemal antibody absorption test (FTA-ABS) confirmatory tests. If syphilis is diagnosed, active treatment should be given before pregnancy in March; if already pregnant, treatment should be recommended during the first three months and the last three months of pregnancy using penicillin [1] while observing changes in RPR titers. Timely and regular treatment of syphilis in pregnant women is the most effective measure to reduce the incidence of congenital syphilis. Follow-up work for congenital syphilis is more challenging due to various reasons. Cooperation from parents is essential after birth, with follow-up reviews conducted at 2, 4, 6, 9, and 12 months post-birth to perform syphilis serology until the titer continues to decline or becomes negative. In cases of recurrence, re-treatment is necessary to avoid late syphilis occurrence.