 This study examined the implementation of a national syphilis follow-up system in Cambodia to improve syphilis management in maternal and child health, MCH, services. The study found that the national syphilis follow-up system was effective in increasing syphilis testing and treatment among pregnant women. However, there were still barriers to accessing syphilis testing and treatment such as late antenatal care, long distances to RPR testing and treatment, and partners not supporting women to reach the health facility. Additionally, providers and managers reported a lack of communication across services, insufficient skills to treat infants, and absence of clear guidance regarding the revised follow-up system. These findings informed improvements to syphilis management in MCH services in Cambodia. This article was authored by Therese Delvos, Savannarie Tuat, Seronkia Deng, and others. Thank you for watching.