Background: Secondary syphilis is a common sexually transmitted infection with diverse clinical manifestations. This study aims to determine the prevalence, age and sex distribution, and various clinical presentations of secondary syphilis in patients attending the STD outpatient department. Methods: This cross-sectional descriptive study was conducted from June 2021 to May 2022 at the Institute of Venereology, Rajiv Gandhi Government General Hospital, Chennai. The study included 50 patients above 18 years of age with clinical manifestations of secondary syphilis confirmed by VDRL and TPHA tests. Data on demographic characteristics, sexual practices, clinical features, and associated STIs were collected and analyzed using STATA version 14. Result: Most participants were aged 21-30 years (82%) and predominantly unmarried (80%). Promiscuous behavior was reported by 96%, and 90% had multiple sexual partners. The most common clinical presentations were lesions over palms and soles (48%) and hyperpigmented macules and patches (72%). Associated STIs included HIV/AIDS (8%). Conclusion: Secondary syphilis is prevalent among young, educated, and unmarried individuals with high-risk sexual behaviors. Targeted interventions and routine screenings are crucial for effective management and prevention.