The Australian Gonococcal Surveillance Programme monitors the antibiotic susceptibility of Neisseria gonorrhoeae isolated in all states and territories. In 2008 the in vitro susceptibility of 3,110 isolates of gonococci from public and private sector sources was determined by standardised methods. Different antibiotic susceptibility patterns were again seen in the various jurisdictions and regions. Resistance to the penicillins nationally was at 44% and ranged between 25% in Queensland and 73% in South Australia with the exception of the Northern Territory, where the proportion of drug resistant strains was 4%. Quinolone resistance in gonococci isolates also continued to increase so that nationally 54% of all isolates were ciprofloxacin-resistant, and most of this resistance was at high minimal inhibitory concentrations (MIC) levels. The proportions of quinolone resistant gonococci detected ranged between 80% in South Australia and 31% in Western Australia. All isolates remained sensitive to spectinomycin. Approximately 1.1% of isolates showed some decreased susceptibility to ceftriaxone (MIC 0.06 mg/L or more) and azithromycin resistance was also present in low numbers of gonococci with MICs up to 16 mg/L. A high proportion of gonococci examined in larger urban centres were from male patients and rectal and pharyngeal isolates were common in men. In other centres and in rural Australia the male to female ratio of cases was lower, and most isolates were from the genital tract.