We present a record of events that led to the creation of the Puerto Rico Case Investigation and Contact-Tracing System (CICTS) to monitor and control the spread of severe acute respiratory syndrome coronavirus 2 in Puerto Rico. The development of the CICTS is a significant step toward establishing a comprehensive infectious disease surveillance system in Puerto Rico. Furthering the development of a CICTS infrastructure is critical in the response against future emerging infectious diseases in the region. (Am J Public Health. 2022;112(2):223-226. https://doi.org/10.2105/AJPH.2021.306584).