While many countries recognize the importance of collecting and using ART data, ART surveillance systems and other ART data collection tools, such as registries or repositories, vary according to ownership, reporting responsibility, type of data being reported, information being reported, data quality and validation activities, public reporting of success rates, reporting requirements, and data protection around the world. However, there is a need for ART surveillance systems to be simple, flexible, acceptable, representative, timely, and stable as well as to have high data quality, sensitivity, and positive predictive values. This chapter will explore each of these areas as they relate to ART surveillance.