Serological testing for syphilis is an important tool in the prompt and accurate diagnosis of the disease. Usually a non-treponemal screening test like the Venereal Diseases Research Laboratory (VDRL) or the Rapid Plazma Reagin (RPR) test is initially done to detect antibodies produced in response to infection with Treponema pallidum. If reactive, the non-treponemal test result is confirmed by a more specific, treponemal antigen-based test like Treponema pallidum Hemagglutination Assay (TPHA) or the Fluorescent Treponemal Antibody Absorption (FTA-ABS) test. The activities of the TPHA and VDRL tests are complementary and the combined use of the two tests provides an excellent screen for the detection or exclusion of syphilis at all stages. In Europe, a screening combination comprising the VDRL test and the TPHA test are widely used. The FTA-ABS test is often used as a confirmatory test in samples showing reactivity in other assays. Unfortunately, VDRL and TPHA test combinations don't lend themselves readily to automation, and the FTA-ABS is laborious and time-consuming. The Enzyme Linked Immunosorbent Assay (ELISA) for antibody to T.pallidum has been shown to offer several advantages over the current tests that can easily be automated and eliminate the subjectivity of visual reading. Western blot (WB) is as sensitive and more specific than the FTA-ABS test which makes it a useful additional confirmatory test or an alternative to the FTA-ABS test, particularly with problem sera.