Pest control is required for protecting the food supply and for controlling disease vectors. Unfortunately, there is no perfectly safe form of pest control. Pesticides are commonly used for pest control. Pesticides are defined under the US Federal Insecticide Fungicide and Rodenticide Act(FIFRA) as any substance or mixture of substances intended to prevent, destroy, repel, or mitigate pests, and any substance or mixture of substances intended for use as a plant regulator, defoliant, or dessicant(40 CFR Part 152). Currently in the United States, there are 890 active ingredients registered as pesticides. Approximately one billion pounds of active ingredient are used in the US per year. Unlike most chemicals(anti-neoplastic and anti-micobial medications are the principal exceptions), pesticides are specifically designed to kill and cause harm. Because society allows these chemicals to be disseminated into the environment, it is important to monitor the health effects associated with these releases. This represents an important justification for establishing and maintaining surveillance systems for acute pesticide-related illness and injury. A comprehensive, national surveillance system for acute pesticide-related illness and injury does not currently exist in the US. Although the United States has several surveillance systems for this condition, none provide a complete understanding of the problem of acute pesticide-related illness and injury. The Toxic Exposure Surveillance System(TESS) and Bureau of Labor Statisitics(BLS) are useful for assessing magnitude and trends. The state-based surveillance systems are more useful for timely identification of outbreaks and emerging problems. Efforts are underway to increase the number of states that conduct surveillance, and to broaden the use of the standardized case definition to facilitate aggregation of data across states. Through such efforts, a comprehensive, national surveillance system may be attainable.