Aim: This cross-sectional study comprising quantitative and qualitative analysis of clinical practices was designed to evaluate the quality and relevance of management of sexually transmitted infections (STI) based on a syndrome approach by private pharmacies in Hanoi in 2010 compared to a similar study conducted in 2000.Methods: One investigator played the role of a customer presenting signs of STI. He visited 60 randomly selected private pharmacies in Hanoi and noted the treatments, questions and advice provided by pharmacists.Results: The results show that pharmacists proposed a treatment for 87% of cases of urethral discharge and 30% of cases of genital ulcers. The patient was not asked any questions in 55% of cases. None of the prescriptions complied with national guidelines. Only 8.3% of pharmacists/shop assistants asked the “patient” questions concerning the spouse/partner and 20% provided advice (the use of condoms in 26.6% of cases and a screening test for HIV in only one case). Pharmacists/shop assistants recommended consulting a doctor in only 43.3% of cases or a specialized STI clinic in only 16.7% of cases.Conclusion: The behaviour of private pharmacists/shop assistants in Hanoi have not changed over the last ten years (2000-2010). They readily treat STI inappropriately and provide little advice concerning prevention, screening and treatment. In the age of the HIV pandemic and microbial resistance to antibiotics, patients with STI should be advised to seek management by competent public services.