Introduction - Surveillance of rectal lymphogranuloma venereum (LGV) provides an overview of trends in case numbers from its emergence in 2003 through the end of 2009 in France. Methods - The surveillance system relies on a network of laboratories. Genotyping of rectal samples positive for Chlamydia trachomatis allows for the differentiation of LGV cases caused by genovar L strains from cases of rectal infection caused by non-L genovar strains (D-K). Patient age and HIV status are the only available data. Results - The number of LGV cases increased in 2007 (170 cases) and 2008 (191 cases) compared to 2005 (117 cases) and 2006 (140 cases) and decreased in 2009 to 160 cases. The diagnosis is made in men who have sex with men (MSM), 90% of whom are HIV-positive. One case of rectal LGV in a woman and a few cases of non-rectal LGV were identified. Conclusion - Caution is warranted when interpreting the decline observed in 2009. Indeed, the 2010 data do not show a decline in infection within the male homosexual community and, furthermore, indicate that the epidemic, which had previously been limited to HIV-positive MSM, appears to be spreading to HIV-negative MSM. Monitoring in 2011 will confirm whether or not this trend is continuing. Finally, the identification of a female case indicates that transmission to the heterosexual population is possible, even if it remains exceptional for now. (R.A.)