Cuffe KM, Kang JDY, Dorji T, et al. - Individual-level factors are identified as important predictors of congenital syphilis (CS), and in light of the geographic focus of CS, researchers determined county-level factors associated with CS. From the National Notifiable Diseases Surveillance System, they analyzed county CS cases during the periods 2014–2015 and 2016–2017. A predictive model was created to determine county-level factors linked with CS and these were used to predict counties at elevated risk for future CS. The final model led to identification of 973 (31.0% of all US counties) counties at elevated risk for CS (sensitivity, 88.1%; specificity, 74.0%). The following county factors were identified as predictors of CS: metropolitan area, income inequality, primary and secondary syphilis rates among women and men who have sex with men, and population proportions of those who are non-Hispanic black, Hispanic, living in urban areas, and uninsured. Prediction of 2016–2017 CS cases was done with the predictive model using 2014–2015 CS outcome data (area under the curve value, 89.2%). In view of the dire consequences of CS, increasing prevention efforts remains significant. The ability to predict counties at most raised risk for CS based on county factors may aid target CS resources where they are required most.