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Syphilis does the most damage to the body during its third or tertiary stage. Tertiary syphilis usually occurs after primary and secondary have occurred but varies in how long it takes for tertiary to appear. However, not all cases of syphilis, even untreated, will advance to tertiary syphilis.

For normal tertiary syphilis it can be as little as a year or two after being infected to over 30 or 40 years after initial infection for the third stage to develop. In rare cases a patient may develop neurosyphilis, usually a form of tertiary syphilis, as early as between the primary and secondary stages. Neurosyphilis is syphilis of the brain and nervous system and can be particularly devastating as it does significant, even lethal, damage to the brain.

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