Public health surveillance is defined as "the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health." National surveillance systems have existed for decades in the realms of economics, criminal justice, and public health, as well as others. Firearm injury accounts for 30,000 lives lost each year with the Nation’s public policy response to the burden of firearm injury and deaths being hindered by the lack of data to describe and monitor the problem. This chapter provides argument for the value and necessity for the Nation to institute efforts to establish a surveillance system on violent deaths, especially those related to the use of firearms. It describes the development of the National Violent Death Reporting System (NVDRS). Even though homicide and suicide are the second and third leading cause of death among people, data for violent deaths have been inadequate. Two systems of data on violent deaths exist at the national level with marked limitations: the FBI’s Supplementary Homicide Reports (SHR) and the National Center for Health Statistics’ National Vital Statistics System. A pilot reporting system for violent deaths, the NVDRS was jointly developed by the National Violent Injury Statistics System (NVJSS) Workgroup with uniform data elements, software, reporting protocols, and training manuals for the reporting system. The data would be collected in an incident-based format allowing for more accurate characterization of complex events, more useful descriptions of rare events, and allow for the monitoring of trends and comparison across jurisdictions. Under the proposed NVDRS, information would be improved on available violent injury data. The drive to create NVDRS occurred due to calls to develop a surveillance system for firearm injury or more generally, violent injury. By providing more comprehensive, uniform, and accurate data about violent death, NVDRS will help move toward reducing the problem of lethal violence in America. Comments and references