Syphilis is currently an emerging health problem, especially in high-income countries. Infection rates have increased significantly in European countries such as the United Kingdom and Spain in the last 20 years. As a result we are now seeing an increase in maternal infection, acquired during pregnancy, with a high risk of transmission to the developing fetus, which is associated with adverse neonatal outcomes. Although the Spanish incidence of congenital syphilis is below the World Health Organization (WHO) elimination threshold (50/100,000) and health measures recommended by WHO have been achieved, congenital syphilis is still a social and public health problem. Antenatal care follow-up protocols are sometimes not accurate enough to uncover the infection during pregnancy and therefore to avoid consequences in the newborn. Infection during pregnancy may be missed if it occurs after the screening period. We report a case of severe congenital syphilis in order to emphasize that in the 21st century, fetal infection still occurs in developed countries, although it is easily preventable and treatable.