This report describes a case of secondary syphilis presenting with an atypical cutaneous eruption and acute spastic quadriparesis. The etiology of the cutaneous and neurologic manifestations was obscure until cerebrospinal fluid (CSF) studies revealed pleocytosis, elevated protein, and a positive CSF, VDRL, and fluorescent treponemal antibody (FTA). These findings, correlated with the histologic presence of plasma cells in the dermal infiltrate, indicated secondary syphilis with acute syphilitic meningitis as the cause of the patient's illness. Therapy with intravenous penicillin, 20 million units daily for 3 weeks, resulted in almost complete recovery.