During the years since certification of smallpox eradication, the power of infectious disease surveillance has been greatly increased by new biotechnical and electronic technologies. These technologies have transformed the way that surveillance can be used to contribute to public health, and to infectious disease eradication and elimination. In addition to permitting precise geographical placement of infections by incorporating the most up to date geographical positioning systems, infectious disease surveillance can now also provide more comprehensive understanding of the spread and risks of infections because of genomic sequencing that leads to more meaningful epidemiological analysis. These new technologies have made infectious disease surveillance an even more powerful and timely tool than it was during the period of smallpox eradication. Future surveillance will continue to refine these technologies, and adapt newer ones such as rapid point of care diagnostics and hand held communication devices that will lead to more timely and accurate reporting from health facilities. These technologies will also lead to the possibility of direct participation in surveillance by individuals who will be able to report their own disease syndromes, those of their neighbors, or those of domestic and wild animals at the animal/human interface.