Over the past five years, there has been a paradigm shift in the way that rapid diagnostics and genomic technologies have been applied to sexually transmitted infections. These changes have led to new insights into the emergence, evolution and transmission of sexually transmitted pathogens, including those that are antimicrobial-resistant. This talk will provide an overview of how novel microbiological approaches are being used to diagnose and track STIs, with a particular focus on gonorrhoea and syphilis, using examples from the Australian context.