OBJECTIVE To assess the extent of syphilis seropositivity in pregnant women, identify the risk factors associated with it and re-evaluate the need for routine antenatal care screening for syphilis. METHODS Prospective cross-sectional study. METHODS Three teaching hospitals of Addis Ababa University Faculty of Medicine, Department of Obstetrics and Gynecology, Addis Ababa, Ethiopia. METHODS A total of 410 pregnant women attending antenatal care from April 1997 to September 1997 were included in the study. Subjects were excluded from the study if they were registered prior to the study period. METHODS Seropositivity for syphilis, and socio-demographic factors related to it. RESULTS Among the study population, twelve women (2.9%) were positive for Venereal Disease Research Laboratory (VDRL). The study showed that the seropositive women were more likely to be those with lesser income (<600 birr/month). Past history of abortion was significantly associated with VDRL seropositivity (p<0.05). Similarities and differences between the findings of this study and other national and international reports have been noted. CONCLUSIONS It is necessary to conduct a large scale study to evaluate if screening is cost-effective and establish risk scoring methods.