Abstract: OBJECTIVE To investigate the epidemiological characteristics of pregnant women and neonates infected with Treponema pallidum in Shanxi Province from 2013 to 2023 so as to provide scientific bases for formulating prevention and control strategies for syphilis in pregnant women and neonates. METHODS The case data of 5 683 pregnant women and puerpera with Treponema pallidum infection were collected from the Maternal and Child Transmission Management System of Shanxi Province between 2013 and 2023. The clinical characteristics, regional distribution, treatment status, pregnancy outcomes and neonatal condition were statistically analyzed. RESULTS The pregnant women and puerpera were characterized by: the puerpera with infections were mainly aged between 20 and 35 years old, workers and unemployed people (94.63%) were dominant among all the occupations; 83.98% of them had the degree of lower than junior college; latent syphilis was dominant among the clinical stages, accounting for 70.37%. The number of infection cases reached up to the peak (738 cases) in 2018, showing an overall trend of first increasing and then decreasing. With the regard to the treatment status, 4 369 of 5 683 pregnant women and puerpera with infections received anti-syphilis therapy, and the total treatment rate was 76.88%; the treatment rate showed an upward trend year by year, remarkably increasing from 43.96% in 2013 to 91.64% in 2023. As for the neonatal outcomes, the average birth weight of the neonates was 3 239.91 g, with the average height 49.74 cm; totally 5 603 cases survived, with the survival rate 99.08%; totally 112 neonates had confirmed or suspected infections, with the infection rate 1.98%; 4348 (76.89%) of the neonates who survived received the prophylactic therapy. CONCLUSIONS The treatment rate of pregnant women and puerpera with Treponema pallidum infection is remarkably increased in Shanxi Province from 2013 to 2023, the neonates have favorable prognosis, and the infection rate is low. It is suggested that the propaganda and education of harms and prevention knowledge of syphilis are further strengthened, the cognition level of the public should be improved, the allocation of medical resources should be further optimized so as to continuously improve the maternal and infant health outcomes.