A study in a tertiary care hospital of Madhya Pradesh investigated the prevalence of Syphilis co-infection among HIV-positive individuals. Examining 445 patients over a year, we found that 9.2% were reactive for Syphilis, with overall (56.1%) exhibiting active infection. This prevalence was higher compared to previous studies. The findings highlight the importance of routine syphilis screening of HIV-positive individuals in India, emphasizing the need for regular analysis to optimize prevention and treatment strategies for co-infections.