Congenital syphilis, a vertically transmitted infection resulting from inadequate or absent maternal treatment during pregnancy, remains a serious public health problem due to its high neonatal morbidity and mortality despite available preventive measures. This study aimed to analyze temporal trends and the profile of hospitalizations for congenital syphilis in Brazil from 2019 to 2024.

Cross-sectional, descriptive, quantitative study using secondary data from the SUS Hospital Information System (SIH/SUS) via DATASUS. Included hospitalizations for congenital syphilis between 2019 and 2024. Variables analyzed included number of hospitalizations, type of admission (emergency or elective), deaths, sex, age group, and race/color. Descriptive analysis identified temporal, regional, and epidemiological profile variations.

A total of 116,423 hospitalizations were recorded, 97.74% of them emergency admissions. Numbers increased until 2021 (peak: 21,346 hospitalizations) and decreased by 20.03% in 2024. The Southeast (36.97%) and Northeast (34.37%) regions had the highest numbers, particularly São Paulo (14.34%), Rio de Janeiro (13.52%), and Pernambuco (9.48%). Elective admissions were most frequent in Rio de Janeiro (20.06%), Rio Grande do Sul (19.11%), and Acre (14.70%). In emergency settings, in São Paulo (14.50%), Rio de Janeiro (13.37%), and Pernambuco (9.52%). There were 214 deaths, peaking in 2022 (43 cases) and decreasing to 31 in 2024. The Northeast (37.85%) and Southeast (30.84%) had the most deaths. Hospitalizations were slightly more common in females (51.38%), but deaths predominated among males (53.74%). Brown and white individuals represented most hospitalizations (50.34% and 19.09%) and deaths (56.07% and 16.82%). Children under one year accounted for 98.34% of hospitalizations and 71.5% of deaths, though detailed clinical information was lacking.

Congenital syphilis remains a persistent public health challenge in Brazil despite the decline in 2024. The predominance of emergency admissions, high frequency in children under one year, and ongoing preventable deaths underscore the need to intensify screening, early diagnosis, and adequate treatment during prenatal care.