There is a paucity of literature on best practice in public health surveillance systems that are relevant to the monitoring of trachoma. We have outlined some aspects of current practice in surveillance such as the attributes of good quality systems and factors found to be problematic in the literature so far. There is some information on good practice in sampling, and advantages and drawbacks of the school-based screening approach reported through the literature. It is fair to conclude that the current approach to trachoma surveillance in Australia is consistent with practices around the world, and the recent addition of measurement of trachoma prevalence using a random cluster sampling adds value to the estimates of trachoma prevalence made by using the rapid assessment approach in the surveillance system.