Twenty neonates were diagnosed with CS with 1 death, mean gestational age was 37.5 weeks and the mean birth weight was 2.77kg. Twelve neonates were males. Three of the 20 neonates had clinical features of congenital syphilis. Of the 20 neonates with CS, only 12 (60%) of the mothers had attended clinics for antenatal care. Between November 2021 to June 2022, Standerton hospital and surrounding clinics experienced a severe shortage in Benzathine penicillin supply, resulting in a lack of treatment among some pregnant women. 