Syphilis is an ever changing disease with an increasing incidence in the last years. Diagnosis of neurological damage remains on cerebrospinal fluid studies and serologic test in patients with appropriate clinical manifestations. Modern neuroimaging techniques are now available in the diagnostic workup of patients with neurosyphilis. Our experience with such techniques in two patients with meningo-vascular syphilis and general paresis points out to the role of magnetic resonance imaging in disclosing ischemic lesions in these patients, although these lesions were not absolutely specific of the disease.