Environmental and climatic changes and the mobility of ever-increasing numbers of people increase the risks for the emergence and reemergence of infectious diseases. Since communicable disease trends change rapidly, many nations have developed individualized communicable disease surveillance systems. In Korea, notification of the incidence of communicable diseases has been the most important form of surveillance since 1954. In addition, the government has established various surveillance systems since the late 1990s. Current problem areas of surveillance systems are the low reporting rate, a lack of representativeness, a lack of participation, and poor utilization. The government has not fully evaluated these systems. For many diseases, it is of critical importance to maintain the confidentiality of surveillance data. Issues of confidentiality are critical and must be considered in order to obtain valid data and protect those surveyed. In the future, we have to improve the reporting rate, enhance collaborations with veterinarians and gain the full support from the governmental departments of agriculture and defense. Surveillance systems should be evaluated regularly. The most dynamic and important part of surveillance is the feedback mechanism. To develop positive feedback, we must disseminate the collected and analyzed information and give reimbursement to the reporters. We have to built close partnerships with governmental agencies, international organizations, research institutes, private health corporations, and academia.