This prospective cross-sectional study conducted at the ICTC and PPTCT centers of a tertiary care hospital of Madhya Pradesh aimed to identify risk factors associated with HIV and syphilis co-infection among individuals seeking HIV testing. Over a year, 445 HIV-positive individuals were evaluated. Results showed a 9.21% (41/445) HIV-syphilis co-infection rate, with 56.10% having an active syphilis infection. Co-infection was more prevalent in heterosexual males (5.4%) compared to females (0%). Notably, 95.45% of co-infected individuals were below 55 years, with 59% aged 25-34 years.