Syphilis is also known as 'the great imitator' for its ability to mimic many diseases due to its extensive range of clinical manifestations. This review aims to provide an update on the clinical presentation, diagnosis and treatment of ocular syphilis. It manifests in a spectrum of ways that can occur at any stage of the disease, and may be the only presenting feature of systemic syphilis, with the most common finding being panuveitis. The diagnosis is usually aided by serology testing: nonspecific treponemal antibodies (for screening and follow-up) and specific treponemal antibodies for confirmation of the diagnosis. The treatment for ocular syphilis is similar to neurosyphilis and includes intravenous aqueous crystalline penicillin.