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Eight US cities experienced large outbreaks of syphilis among men having sex with men (MSM), beginning during 2000–2001. Provider-assisted partner notification via disease intervention specialists has traditionally composed a large part of syphilis control efforts.Report current effectiveness of syphilis partner notification for MSM and identify related problems and solutions.One thousand five hundred seventeen MSM diagnosed with syphilis claimed 10,254 sex partners. Many claimed anonymous partners (median = 65%), or provided insufficient locating information (median = 42%). Median cases found per index case were 0.09 (total = 116), although an additional 197 partners had been previously treated. Principal impediments to partner notification fell into 3 areas: (1) diagnosis outside health department settings delayed interviews, (2) partners were often anonymous, and (3) mistrust among MSM, public health professionals, and health care providers in private settings.Characteristics of the current outbreaks among MSM make traditional partner notification more difficult than in the past. Some modifications, complements, and even alternatives to partner notification are either planned or in operation.