BACKGROUND: We analyzed the positive rates of Mediace Rapid Plasma Reagin (RPR) (Sekisui, Japan) and Mediace Treponema pallidum Latex Agglutination (TPLA) (Sekisui) assays. Positive results were compared to those of immunochromatography assay (ICA) and fluorescent treponemal antibody absorption (FTA-ABS) tests. METHODS: We used samples of patients visited at a university hospital from April 2010 to May 2011. The rates of positive results were calculated with 36,343 RPR results and 5,934 TPLA results. In addition, 237 positive samples with Mediace RPR or TPLA were re-tested with ICA and FTA-ABS. Mediace RPR and TPLA tests were performed with Toshiba 200-FR Neo (Toshiba, Japan). RESULTS: The rates of positive results were 0.47% (169/36,343) and 3.52% (209/5,934) with RPR and TPLA, respectively. Among the 237 sera that tested positive with RPR or TPLA, 76 were RPR(+)/TPLA(+), 28 were RPR(+)/TPLA(-), and 133 were RPR(-)/TPLA(+). When compared to the ICA results, 86.84% (66/76) of the RPR(+)/TPLA(+) sera were ICA(+), 3.57% (1/28) of the RPR(+)/TPLA(-) sera were ICA(+), and 54.89% (73/133) of the RPR(-)/TPLA(+) sera were ICA(+). Only 67.11% of the TPLA(+) sera demonstrated positive FTA-ABS results. However, 100% of the TPLA(-) sera yielded negative FTA-ABS results. ICA and FTA-ABS had a 96.59% positive agreement rate and an 80.68% negative agreement rate. CONCLUSIONS: These results demonstrate that Mediace TPLA has a low positive agreement rate with FTA-ABS. Although Mediace RPR and TPLA have advantages associated with automated methods, positive results should be confirmed with other treponemal tests, due to the high false positive rates.