Detectives hunting the suspect have issued an image of the suspect caught on CCTV near to the scene of one of the attacks.
The latest incident saw a 30-year-old woman stabbed in her thigh. She reported a sharp pain which was later confirmed as a puncture wound.
West Midlands Police believe it is linked to similar attacks in June and October.
The June incident saw a 20-year-old woman on a night out stabbed twice in the thigh and buttock by a man wielding what appeared to be a hypodermic needle.
Detective inspector Julie Woods, from Force CID, said: “We have received five reports in total over the last year-and-a-half and although the women have not been left with any obvious physical injuries they have had to endure an agonising wait to check that they have not suffered any long-lasting health effects.
“While we have been unable to confirm exactly how the injuries were caused, it is believed that a hypodermic needle may have been used on each occasion, with young women being specifically targeted.
“Due to the nature of the offences, victims have not realised they have been injured until hours or days later, which has resulted in limited lines of enquiry.
“But we now have a particularly clear image of a man we want to identify in connection with the attacks and I would appeal for him, or anyone who knows who he may be, to come forward.
“These are strange offences and the motive at this stage is unclear, which is why it’s so important for us to identify the person in this CCTV image as soon as possible.”
Police have now stepped up patrols in Birmingham city centre.
Superintendent Danny Long said: “This is an unusual offence which will understandably cause some concern and we are working extremely hard to find the person responsible.
“Birmingham remains one of the safest cities in the UK in which to enjoy a night out but if anyone sees any suspicious thing he shld report it immediately
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