Backround Gonorrhoea is the third most common sexually transmitted infection (STI) in the Genitourinary Medicine Clinic. Despite high cure rates achieved with the use of intramuscular ceftriaxone, all patients with gonorrhoea are followed up with one test of cure (gonococcal culture) after treatment. This is essential to ensure success of cure hence preventing complications, to screen for and treat concomitant STIs, and to reduce the possibility of re-infection through repeated patient education. A defaulter is defined as a patient who fails to attend follow-up and undergo test of cure within a period of 2 weeks after completion of treatment. Previous studies showed high defaulter rates of 41.1% and 43.8% in 1996 and 1997 respectively. This study aims to determine the defaulter rate of follow-up of patients with gonorrhoea, and to formulate remedial measures to reduce defaulter rate and thereby improve the management of gonorrhoea specifically and all sexually transmitted infections in general. Materials and Methods An audit of defaulter rate of patients diagnosed as gonorrhoea was performed from January 1998 to December 2005 in the Genitourinary Medicine Clinic, Department of Dermatology, Kuala Lumpur Hospital. All patients who failed to attend follow-up visit within 2 weeks after treatment were recorded as defaulters. An analysis was performed on all defaulters from January to December 2005. Results Defaulter rates for patients with gonorrhoea were generally high throughout the years studied, ranging from 35.0% to 48.2%, the highest being in year 2001. Despite continuous and relentless efforts in patient education and counseling, there has been no decreasing trend. In the year 2005, all defaulters were males. Majority (72.1%) of the defaulters were young adults aged between 21 and 40 years. 67.4% of the defaulters were Malay, followed by Indian 14.0%, Chinese 7.0% and other ethnic groups 11.6%. Among the defaulters, 30.2% had repeated gonococcal infection and 38.5% had concomitant STIs. Conclusions More effort is necessary in educating patients to attend follow-up visit after treatment of gonorrhoea. Emphasis has to be made on the importance of confirming cure and thereby preventing complications and transmission to sexual partners. Counseling should also be given to all patients regarding practice of safe sex to prevent gonococcal re-infection and other STIs.