In the present paper is presented the surveillance system for pesticide-related illnesses proposed by the Istituto Superiore di Sanità, in collaboration with the Ministry of Health. Through the collaboration of local or regional poison control centres and local health departments with public hospitals and emergency departments, cases of acute pesticide-related illnesses among persons seeking health care will be registered according to standard procedures. Data collected locally will be transmitted to the Istituto Superiore di Sanità for registration and evaluation of the association between symptoms and type of exposure and for severity of illnesses related to pesticide exposure. These data will be analysed at regular intervals in order to estimate the magnitude of the problem of acute pesticide-related illnesses in Italy and to identify priority areas for implementing public health prevention and intervention programs.