Aim: We aim in this unique case to explore the differential diagnosis and management of an important forgotten disease which continue to rise worldwide and is missed in daily practice. Oral syphilis can be unspecific from the clinical point of view and can be challenging to diagnose.

Method: We present a rare case of primary oral syphilis in a healthy 22 years-old woman who was referred to our clinic for evaluation of multiple persistent oral ulcers which mistakenly thought it was major aphthous ulcers and appeared for 6 months before consultation.

Results: History, clinical examination, microbiology tests are the key to diagnosis in syphilis. Biopsy may not be specific and may lead to misdiagnosis unless if special stain used.

Conclusion: Syphilis is an important public health problem and most cases of syphilis are acquired through sexual transmission, by direct contact with infectious primary or secondary lesions. The effects of untreated and inadequately treated infection include serious complications. Therefore, early diagnosis and management is paramount.