Objective:To understand the epidemiological characteristics and trends of syphilis in Kashgar area of Xinjiang Uygur Autonomous Region and provide a basis for formulating syphilis control measures.Methods:A descriptive epidemiological method was used to analyze the epidemiological characteristics of syphilis cases reported in Kashgar from 2005 to 2020, and the Joinpoint 4.8.0.1 software was used to calculate the annual percent change (APC) and perform trend testing.Results:From 2005 to 2020, 75 331 syphilis cases were reported in Kashgar. The number of syphilis cases increased from 720 in 2005 to 4 275 in 2020. The reported incidence increased from 19.57/100 000 in 2005 to 93.86/100 000 in 2020 in two stages. From 2005 to 2014, the reported incidence increased from 19.57/100 000 to 188.17/100 000, with an average annual increase of 28.24%. From 2014 to 2020, the reported incidence decreased from 188.17/100 000 to 93.86/100 000, with an average annual decrease of 12.58%. The reported incidence of primary syphilis, secondary syphilis, tertiary syphilis and fetal-transmitted syphilis increased first and then decreased with time. However, the reported incidence of recessive syphilis has been on the rise. Since 2018, the ratio of recessive syphilis has exceeded that of primary syphilis, becoming the main epidemic type. The incidence ratio of male to female was 0.97∶1 (37 097∶38 234); all age groups had reported cases, with 20-49-year-old group the most, accounting for 55.65% (41 921/75 331) of the total number of reported cases; occupational distribution was dominated by farmers, accounting for 71.15% (53 595/75 331) of all reported cases, and the proportion of farmers was increasing year by year, from 35.00% in 2005 to 79.04% in 2020.Conclusions:The situation of syphilis in Kashgar was serious in 2005-2020. We should strengthen the publicity of health knowledge and health education,especially strengthen the health education and prevention of young and middle-aged people, farmers, women of childbearing age and other key groups. Additional, the screening that raises syphilis ceaselessly even and detects level, accomplish early discovery, standard report and cure, in order to curb the popularity of syphilis.