Firearm injury surveillance is an important component of public health, especially because the prevention focus of the health care system requires monitoring vital signs of the national population and responding appropriately to potential threats. Firearm injury surveillance systems exist in several States, including California, Massachusetts, and Washington. The importance of these systems is considered in the context of gun control policies. The status of firearm injury data collection and the importance of firearm injury surveillance are reviewed. Challenges associated with collecting data on firearm injuries are noted, the issue of mandatory reporting of firearm-related morbidity and mortality is addressed, and suggestions for maximizing the potential of future efforts in firearm injury surveillance are offered. The authors emphasize advancing the capabilities of firearm injury surveillance to a level that will inform practical policy matters is an important next step. 17 references