AIM: To report a case of postoperative uveitis secondary to syphilis in an elderly patient.METHODS:A 76-year-old Malay man, a case of bilateral immature cataract underwent uneventful right phacoemulsification. There was no history of uveitis before. On day 5 post operation, he developed sudden onset of vision blurring in the right eye. Examination showed generalized cornea edema with moderate anterior chamber reaction and increased intraocular pressure.RESULTS: The patient responded well to topical antibiotic and steroid. The intraocular pressure was controlled with anti-glaucoma agent. However, the patient developed similar episode of pain, redness and poor vision in the same eye after 3 weeks. Ocular examination revealed severe anterior uveitis with presence of mutton fat keratic precipitates. Venereal disease research laboratory (VDRL) and treponema pallidum hemagglutination assay (TPHA) were positive suggesting syphilis. The condition improved markedly with benzathine penicillin injection and topical steroid.CONCLUSION:This case illustrates syphilis as an under-recognized cause of postoperative uveitis in the elderly. Appropriate management with penicillin has showed rapid and remarkable outcome.